Objective To investigate the efficacy of minimally invasive treatment by combination of external fixation with limited internal fixation for unstable distal radius fractures. Methods From September 2003 to September 2007,43 patients with unstable distal radius fractures were treated with external fixation combined with Kirschner wire fixation. According to AO classification,there were 10 cases of C1,21 cases of C2,and 12 cases of C3. Two external fixation clamp stand screws were inserted into the dorsal radius in operation,then external clamp stand was fixed when manipulative reduction were performed after C-arm perspective. The broken bones were sledged by Kirschner wire when articular facet and bone block were not peaceful and could not achieve reduction by traction. When the bone block was instable,a Kirschner wire fixation was needed. Bone graft through a limited incision were performed for bone defect if necessary. Results All of the 43 cases achieved anatomical reduction after the operation. The mean operaton time was 62.4 min (range from 43 to 121 min). And the mean intraoperative blood loss was 15.3 ml (ranged from 6 to 30 ml). The patients were discharged from hospital in 3 to 14 days with a mean of 5.5 days. After being discharged,they were followed up for 6 to 24 months (mean,12 months),during which,re-examination showed bone union and improved articular activities in all the cases. According to the Dienst scale system,30 patients achieved excellent,8 were good,and 5 were fair. The rate of excellent and good results was 88.4% (38/43). Conclusion External fixation combined with limited internal fixation is a simple,reliable and effective method for treatment of the unstable distal radius fractures.

Objective To establish a suitable extraction and purification process line for industrial production of liquiritin. Methods With the extraction rate of liquiritin as index, orthogonal test was used to determine the optimum conditions; with the retention rate of liquiritin and impurity removal rate as the indexes, orthogonal test was used to optimize the best ultrafiltration process parameters. Results The optimum extraction conditions were: 24 times 0.75%ammonia water, extracted three times, each time under 60 min. The liquiritin average extraction rate was 72.3%. The best ultrafiltration process parameters were: 10 nm inorganic ceramic membrane, pressure of 0.12 MPa, temperature of 25 ℃. The liquiritin average retention rate was 98.9%, and the average removal rate of impurity was 23.3%. Conclusion This process has low production cost and good safety, and is suitable for industrial application.

Objective To explore the effect of acupuncture combined with facilitated technique on lower limb function and activities of daily living of stroke patients.Methods 120 stroke patients with lower limb palsy were divided into the group Ⅰ (treated with acupuncture combined with facilitated technique), group Ⅱ (treated with acupuncture), third group Ⅲ (treated with facilitated technique) and the group Ⅳ (treated with medicine). The lower limb function and ADL of four groups were evaluated with Functional Ambulation Classification (FAC), Fugl-Meyer Assessment (FMA), Modified Barthel Index (MBI) before and 10 weeks after treatment.Results The scores of FAC, FMA and MBI of all the groups improved significantly, but it was more significantly in the first group than the in other groups (P<0.01), in group Ⅰ, Ⅱ, Ⅲ than in group Ⅳ (P<0.01). The difference between the group Ⅱ and Ⅲ was insignificantly(P>0.05).Conclusion Acupuncture combined with facilitated technique can improve the lower limb function and activities of daily living of stroke patients more effectively.

Objective To observe the effect of the early reinforced control ability training of the trunk and pelvis on the motor function of patients with stroke.MethodsFifty-six patients with stroke were randomly divided into the therapy group and control group with 28 cases in each group. The patients of two groups were treated with regular rehabilitation training, forty-five minutes at a time, twice one day; at the same time the patients of the therapy group were administrated with the control ability training in the trunk and pelvis, twenty minutes at a time, twice one day. The Fugl-Meyer Assessment scale (FMA), the Barthel Index (BI) and functionality ambulation category (FAC) were used to assess the motor function of the patients, before and after the treatment.ResultsTwo months after treatment, there was a significant increasing in the FMA, BI, FAC and hemiplegia gait analysis assessment in the both groups ( P<0.05～0.01), but the walking ability of the therapy group was significantly better than that of the control group ( P<0.05).ConclusionCombined the early reinforced control ability training of the trunk and pelvis with routine rehabilitation training is obvious effect on the motor function of the patients with stroke.

Objective To elucidate cerebral cortical response to esophageal acid exposure in normal individuals by functional magnetic resonance imaging (fMRI) and the characteristics of activity. Methods Fifteen volunteers were received intraesophageal perfusion with either 0.9% of sodium chloride or acid (0.1 mmol/L HC1) solutions. The modified block-design model of fMRI scanning was performed simultaneously. All of 32 minutes were needed for resting (A, 8 minutes), 0.9% of sodium chloride perfusion (B,8 minutes), acid perfusion (C,8 minutes) and 0.9% of sodium chloride perfusion again (D,8 minutes). Each chunk was consisted of 160 scans and every scan contained 3 seconds. Six hundred and forty scans were collected in all. The clinical response to esophageal acid exposure was observed and the changes in the cerebral regions was statistically analyzed. Results After perfusion of 0.9% of sodium chloride or acid, 10 out of 15 volunteers had chemosensitive complaints, such as pain in pars laryngen pharyngis, heartburn and chest complaint. The initial active domains involved deutocerebrum, anterior part of callosal gyrus, left side of insula, two sides of amygdale and subiculum hippocampi, two outers of forehead cortex. The provoked regions of acid perfusion (C-A) and 0.9% of sodium chloride perfusion again (D-A) were as same as that of the activated domains by initial perfusion of 0.9% sodium chloride (B-A). The intensity and amplitude of most provoked regions increased gradually(D-A> B-A, P< 0.01). Conclusions The two different stimulations of saline and acid provoke similar cerebral regions that may act in the regulation of esophageal sensitivity. There are the evidences of the central mechanism of esophageal visceral hypersensitivity by acid perfusion.

Objective To investigate the changes of esophageal visceral sence stimulated by esophageal distention in rabbits and the protein expressions of calcitonin gene related peptide(CGRP),P substance(SP),5-hydroxytryptamine(5-HT),Fos protein in central nervous system(CNS).Methods Twenty New Zealand rabbits were randomly divided into experimental group(n=8,received esophageal distention with 0.9 cm balloon for 30 s twice a day for 14 days),control group(n=6,received esophageal stimulation without balloon for 30 s twice a day for 14 days)and blank control grouop(n=6).The esophageal visceral sense was evaluated by animal behavior scores.The expressions of SP,CGRP,5-HT and Fos protein esophagus mucosa,spine,nucleus tractus solitari (NTS),periaqueductal gray(PAG)and thalamus were measured by immunochistochemistry.Results At the same behavior scores,the tube diameter of experimental group was significant lower than those of control group(P＜0.05).The expression of SP in esophagus mucosa,spine and NTS was significant increased in experimental group compared to two control groups(P＜0.05).The expression of CGRP and Fos in esophagus mucosa.spine,NTS,PAG and thalamus was increased in experimental group compared to two control groups(P＜0.05).The expression of 5-HT in esophagus mucosa and spine was higher in experimental group than that in control and blank control groups (esophagus: 27.67±3.27 vs 11.00±1.79 or 11. 17±1.33;spine:24.00±5.22 vs 11.33±2.94 or 11. 83±2. 48, P＜0. 01). But the expression of 5-HT in PAG was lower in experimental group( 13. 17±2.04) than that in control 17.67±2.07)and blank control (16.83±2.32) groups (P＜0. 05). There was significant correlation between CGRP and Fos, SP and Fos, CGRP and SP in spine (r=0. 813,0. 779,0. 772,P=0. 025,0.034, 0. 036, respectively). Conclusions Esophageal hypersensitivity may be induced by esophageal distention. The expresstion of SP, CGRP, 5-HT was increased in the esophageal mueosa and CNS, which indicate that these neurotransmitters and CNS may play an important role in the increase of esophageal visceral sense.

Objective To study food-borne disease related behavior of the floating population in Hangzhou city. Methods A questionnaire on food-borne disease related behaviors was formulated based on Delphi method. A family-based retrospective investigation was conducted by unified trained investigators to analyze the frequency of food-borne disease related behaviors of family food providers during the past month in several floating-population centers of Hangzhou city. The investigation was conducted among 150 adults of every survey spot quarterly during a one-year period. Data were analyzed using Mann-Whitney U test. Results According to all 1 781 valid recovery questionnaires, 82.42%subjects had a family income less than 50 000 yuan per year and 87.42%of them had junior-middle-school or lower levels of education. The proportions of subjects who always cleaned kitchen tools, covered the garbage can and kept house out of flies, roaches and mice were 42.50%, 55.87% and 61.09%, respectively. The proportions of subjects who always purchased intact packaged food and food under warranty were 39.70%and 52.33%, respectively. The proportions of subjects who always used tapped water, cleaned hands before food processing, cooked eggsand other foods till well-done were 66.03%, 51.94%, 53.62%, 35.99% and 32.62%, respectively. The proportions of subjects who always stored food in containers with cover and for no more than 3 days in freezer were 20.89%and 30.88%, respectively. The frequencies of food-borne disease related behaviors mentioned above were significantly higher among migrants who originated from urban areas, received education above junior-middle-school and had a family income no less than 50 000 yuan/y than the others (P<0.05). Conclusion In order to correct the risky behaviors during food consuming, processing and storage, targeted intervention is necessary among family food providers of floating population families.

Objective To conduct in‐depth job analysis and needs assessment on advanced midwifery practitioner (AMP) set up at a tertiary hospital .Methods The appraisal structure was designed by the needs assessment framework .Information on AMP′s job needs was collected via in‐depth interviews ,field notes and midwives′diaries .Colaizzi analysis method was used to sort out and analyze all the data .Results Seven themes through AMP′s job needs assessment were presented in the form of6W1H ,including :(1) who was AMP ;(2) whom did AMP serve;(3) what was AMP′s job content ;(4) what scope did AMP work in ;(5) how was the AMP′s practice model ;(6) where was the practical site;(7) why was the job post launched .Conclusions AMP practice at current stage is in its embryonic form of exploration but with huge potential demand ,which still needs to be improved using the needs assessment framework so that a scientific and standard job description can be formed to guide the AMP clinical practice .

In this paper, we address the preparation of the EPC and HEPC sterically stabilized doxorubicin liposomes and report the data collected from further studies on pharmacokinetics in blood for choosing a better carrier in delivering the drugs. The pharmacokinetics of EPC and HEPC sterically stabilized liposomes (EPC-SSL, and HEPC-SSL) in Wistar rats were investigated by HPLC. The results showed that the mean residence time of HEPC-SSL in blood is 23.3 h, while that of EPC-SSL is 12.0 h. In conclusion, HEPC-SSL is a better carrier in delivering the drugs to the extravascular sites when compared with EPC-SSL.
Animals ; Antibiotics, Antineoplastic ; administration & dosage ; pharmacokinetics ; Delayed-Action Preparations ; chemical synthesis ; pharmacokinetics ; Doxorubicin ; administration & dosage ; pharmacokinetics ; Drug Carriers ; chemistry ; Hydrogenation ; Liposomes ; Phosphatidylcholines ; chemistry ; pharmacology ; Rats

Objective To investigate the role of diffusion kurtosis imaging (DKI) in indeterminate solitary pulmonary nodules (SPN) diagnosis and to compare with conventional diffusion weighted imaging (DWI). Methods From March 2016 to Dec 2017, forty-three consecutive patients (30 male, 13 female, age: 56 ± 11 years) with indeterminate SPNs were included. All patients underwent axial multi-b factor DWI (with b values=0, 50, 200, 400, 800, 1400, 2000 s/mm2) examination and were divided into benign group (19 cases) and malignant group (24 cases) according to pathological results of SPN. ADC Kurtosis (K) and Diffusivity (Dk) values were compared between malignant and benign group and among different subtypes of lung cancer using independent t test (normal distribution and homogeneity of variance) and Mann-Whitney U test (skewed distribution or variance). Receiver operating characteristic (ROC) curves were employed to evaluate the diagnostic performance. Results K values were significantly higher for malignant SPNs than for benign SPNs (0.839 ± 0.197 vs. 0.718 ± 0.120;t=2.359, P=0.023). ADC values were found to be significantly higher in benignity than malignant SPNs [(1.605 ± 0.422) × 10-3mm2/s vs. (1.278 ± 0.210) × 10-3mm2/s; t=-3.089, P=0.005). No difference was observed in Dk between the two groups (P=0.922). All parameters cannot differentiate subtypes of lung cancer. The ADC value had higher AUC (area under ROC curve) than that of K value. The sensitivity (70.8％) and accuracy (72.1％) of ADC value was higher than K value, the specificity of both methods was equal. Conclusion DKI is a feasible non-invasive tool which has comparable capability of conventional DWI in SPNs differentiation, although with lower sensitivity and accuracy. DKI can provide additional information for SPNs characterization and has a potential to be a robust way in SPNs interpretation.