Objective To explore the surgical methods for unstable fractures of distal radius and evaluate the clinical results. Methods A retrospective analysis was conducted on 87 patients with unstable fractures of distal radius treated surgically from May 2001 to June 2008. According to AO classification and comminution severity, three methods including plate fixation, external fixation and Kirschner' s pins and plate fixation plus external fixation were employed accordingly. Results Of all, 78 patients were followed up for average 18 months. The result of Cooney's assessment of the wrist was excellent in 44 patients, good in 21, fair in 11 and poor in 2, with excellence rate of 83%. Conclusions The surgical methods should be selected based on different types of unstable distal radius fractures. In the meantime, maximal recovery of the relative length of the radius and ulna, formation of articular surface, volar tilting angle and ulnar inclination angle and reasonable rehabilitation exercises are helpful for the functional recovery of the wrist to a largest extent.

Objective The study aimed to explore the reliability and validity of public health practitioners 'job satisfaction scale. Methods A questionnaire survey was conducted with professional and technical personnel in the province engaged in the work of public health of investigation;they were enrolled through the multi?stage cluster random sampling method for establishing the scale 's internal consistency reliability and structur?al validity. Results The Cronbach's alpha coefficient of the total satisfaction scale was 0.900. The Cronbach's alpha coefficients were 0.896, 0.781,and 0.799 for career development and achievement,relationship and career retention,and income and promotion latitudes,respectively. Four principal components were extracted and the results showed that the cumulative contribution rate was 69.72%and the factor analysis results were basically consistent with the theoretical structure. Conclusion The scale is thus considered to be a reliable and effective measurement tool assessing public health practitioners'job satisfaction,as it had good reliability and validity.

Objective To establish mouse poisoning model by inhaling benzene, and to investigate the induction effect of benzene on the apoptosis of mouse bone marrow cells and its mechanism, and to provide an experimental basis for study on bone marrow toxicity mechanism.Methods 24 male mice were randomly divided into four groups (n=6).The mice in one group were exposed to ambient air (control group)and the mice in the other three groups were exposed to different doses (400,800,1 600 mg·m-3 )of benzene (low,middle and high doses of benzene groups)for 1 5 d in the respective inhalation chambers. At the end of the experiment, the mice were killed. The bone marrow of the mice was obtained. The pathological changes of the bone marrow cells of the mice in various groups were observed under light microscope with HE staining.The apoptotic rates and mitochondrial membrane potential (MMP ) of the mice in various groups were detected by flow cytometry, and the expressions of mitochondrial-deperdent apoptosis related gene proteins were determined with immunohistochemistry method. Results The number of distal and central cells in different doses of benzene groups were significantly reduced,and accompanied by blood sinus expansion in high dose of benzene group.The apoptotic rates of the cells in middle and high doses of benzene groups were obviously higher than that in control group (Ρ<0.01),and there were also significant differences between high dose group and low,middle doses of benzene groups (Ρ<0.05).The MMP was significantly decreased with the increasing of benzene doses, and there were significant differences between middle,high doses of benzene groups and control group (Ρ<0.05).The number of Bax,CytC positive cells in different doses of benzene groups and the number of Caspase-9,Caspase-3 positive cells in middle and high doses of benzene groups were significantly increased compared with control group(Ρ<0.05);the number of Bcl-2 positive cells in different doses of benzene groups was decreased(Ρ<0.05),and number of Bcl-2 positive cells in middle and high doses of benzene groups was decreased compared with low dose of benzene group (P<0.05). Conclusion Benzene with certain dose can induce the apoptosis of mouse bone marrow cells, and promote the expressions of mitochondrial apoptosis related gene proteins. Benzene-induced apoptosis through mitochondrial-dependent apoptosis pathway may be an important mechanism of bone marrow toxicity induced by benzene.

Objective To investigate the gray matter volume differences between adult hypothyroid subjects and healthy controls using voxel-based morphometry (VBM).Methods A total of 28 untreated hypothyroid patients and 28 age and gender-matched uormal controlswere recruited.The coucentrations of their freetriiodothyronine (FT3),free theroxine (FT4),and thyroid stimulating hormone (TSH)were testedfrom their venous blood on the day they accepted MR scanning.High resolution 3D-datawereobtained using 3.0 T MRI scanner.VBM analysis was performed to detect the volume differences between the groups by using voxel-wise two sample t test.Multiple regression analysis was employed to analyze the influence exerted upon gray matter volume by serum FT3,FT4,and TSH concentrationof hypothyroid patients.Results Compared to controls,gray matter volumes in the bilateral superior frontal gyri,left precentralgyrus and bilateral cerebellum were decreased in hypothyroid patients (voxels 211-2 142,t=3.36-3.69,P＜0.01,corrected).No significant correlation between the gray matter volume in the above-mentioned brain regions and the clinical variables (serum FT3,FT4,and TSH concentration) (P＞0.05) was found in the multiple regression analysis.Conclusions VBM analysis revealed that hypothyroid patients exhibited reduced gray matter volume in multiple brain regions.It suggests that the lack of thyroid hormones can lead to the structural abnormalities in adult brain and selective gray matter atrophy in multiple brain regions.

AIM: To study the molecular mechanism in modulation of expression of insulin receptor substrate-1 and-2 (IRS-1,-2) by estrogen and high concentration of insulin. METHODS: The 5′-regulatory regions of IRS-1 and IRS-2 gene were cloned into the pGL3 plasmid with luciferase reporter, and the clones were transfected into HeLa cells. The cells were incubated with estradiol (1 nmol/L) and high concentration of insulin (100 nmol/L). The relatively transcriptional activity of the 5′-regulatory regions of IRS-1 and IRS-2 gene was detected. RESULTS: It was found that the relatively transcriptional activity of the 5′-modulatory regions of IRS-2 reduced markedly after cells were incubated with 100 nmol/L insulin (P

AIM:To investigate the influence of ovariectomy and estrogen replacemeot treatment on profile of gene expression in myocardium by cDNA microarray,and to characterize the targeting genes of estrogen.METHODS:cDNA microarray containing 1 400 rat cDNAs was used to study the genes differentially expressed in myocardium between sham(Ⅰ),ovariectomy(Ⅱ,OVX)and estrogen replacement treatment(Ⅲ,OVX+E2)group.Then down-regulated genes in myocardium of OVX rats were further confirmed by RT-PCR.RESULTS:177 genes were differentially expressed in myocardium between sham and OVX rats,with 91 genes up-regulated and 86 genes down-regulated in OVX rats.164 genes were differentially expressed in myocardium between OVX and OVX+E2 rats,with 113 genes up-regulated and 54 genes down-regulated in OVX rats.There were 54 genes differentially expressed in OVX compared to sham and OVX+E2.They are involved in membrane channels and transporters(18),cell receptors(9),intracellular transducers/effectors/modulator(7)and metabolism(6).Most of the genes(45)were down-regulated in OVX rats and up-regulated in OVX+E2 rats.RT-PCR test confirmed the results of cDNA microarray.CONCLUSIONS:Long-term estrogen replacement may influence the expression of genes involved in membrane channels and transporters,cell receptors,intracellular transducers/effectors/modulator and metabolism.Long-term estrogen replacement has some beneficial effects on ionic concentration and cardiac function which partially comes from the results of influence of expression on Na+,K+-ATPase and Na+/H+ exchanger.Estrogen has an inhibitory effect on the expression of dopamine receptor,which partially clarify the myocardial protection of estrogen.

The aim of this study is to investigate the anti-inflammatory effect of the adenosine derivative N6-(3-hydroxylaniline) adenosine (WS070117M1) on cigarette smoke plus LPS (lipopolysaccharide)-induced chronic obstructive pulmonary disease (COPD) in mice and its mechanism. COPD model was established by exposing male BALB/c mice to cigarette smoke and challenged with LPS inhalation. Supernatants of bronchoalveolar lavage fluid (BALF) were harvested and IL-1β, IL-6, IL-8 and TGF-β1 levels were measured by ELISA (enzyme-linked immunesorbent assay). The number of total white blood cells and neutrophils in bronchoalveolar lavage fluid was counted separately. Lung tissue was stained with Mayer 's hematoxylin and eosin for histopathologic examination. pAMPKa protein expression and distribution of lung tissue were analyzed by immunohistochemistry method. In vitro, levels of AMPKα phosphorylation in phorbol-12- myristate-13-acetate (PMA) differentiated THP-1 cells was detected by immunohistochemistry, IL-8 level in supernatants of cigarette smoke condensate stimulating PMA differentiated THP-1 cells was measured by ELISA. The results showed that WS070117M1 treatment significantly activated AMPKa in the lung tissue. It also resulted in down regulation of IL-1β, IL-6, IL-8 and TGF-β1 levels in bronchoalveolar lavage fluid and IL-8 level in cigarette smoke condensate stimulating PMA differentiated THP-1 cells. In addition, WS070117M1 could inhibit the recruitment of total white blood cells and neutrophils. These results suggest that WS070117M1 may alleviate the airway inflammation by activating AMPK in the lung tissue.

Objective To explore related factors of amputation in patients with diabetes foot ulcer(DFU) and provide the evidence of reducing amputation rate.Methods A total of 307 inpatients with DFU in this hospital from October 2013 to December 2015 were collected and divided into amputation group(n=28) and non-amputation group(n=279).The clinical data and laboratory data were treated with single variable analysis and multivariate Logistic regression analysis.Results Single variable analysis showed that hospitalization time,hyper-sensitive C-reactive(hs-CRP) and fibrinogen(FIB) level were significantly increased in amputation group(P＜0.05) when compared with non-amputation group,and the hemoglobin (Hb) level,high-density lipoprotein cholesterol(HDL) and serum albumin (ALB) level in amputation group were markedly lower than in non-amputation group(P＜0.05).Amputation rate was significantly different among different Wagner grades (P=0.000).Multivariate Logistic regression analysis showed that hospitalization time,Wagner grade were independent risk factors of amputation in patients with DFU,OR values were 1.024(95％CI:1.009-1.039) and 2.779 (95％CI:1.753-4.404),respectively.While HDL was a protective factor of amputation in patient with DFU (OR=0.161;95％CI:0.036-0.729).Conclusion The higher the rank of Wanger in DFU patients are,the longer hospital stay and the higher amputation risk become.HDL is the protective factor of DFU amputation.

Objective: To investigate the epidemiological characteristics of clusters of hand, foot and mouth disease (HFMD) in kindergartens and schools in Jinshan District, Shanghai Municipality from 2016 to 2021, so as to provide insights into improving the prevention and control measurements of HFMD in Jinshan District. Methods: Data of HFMD cases in Jinshan District from 2016 to 2021 were collected through Chinese Disease Prevention and Control Information System, and data pertaining to HFMD clusters in kindergartens and schools were also collected. The scale, temporal distribution, regional distribution and distribution of cluster places were descriptively analyzed. Results: Totally 338 HFMD clusters involving 974 cases were identified in kindergartens and schools in Jinshan District from 2016 to 2021, with an average attack rate of 9.89%. The number of cases in each cluster ranged from 2 to 12 cases, with a median number of 2 (interquartile range, 1) cases, and there were 223 clusters involving 2 cases, accounting for 65.98%. The duration of clusters ranged from 1 to 16 days, with a median duration of 4 (interquartile range, 3) days. HFMD peaked from April to June (136 clusters, 40.24%) and from September to December (176 clusters, 52.07%). All the 11 streets and towns (high-tech zones) were reported HFMD clusters, and the three largest number of clusters were reported in Zhujing Town (72 clusters, 21.30%), Shanyang Town (63 clusters, 18.64%) and Tinglin Town (40 clusters, 11.83%). There were 268 HFMD clusters in kindergartens (79.29%) and 70 in schools (20.71%), and the prevalence of HFMD clusters was higher in kindergartens than in schools (35.51% vs. 17.03%; χ2=31.507, P<0.001). Conclusions HFMD clusters in kindergartens and schools showed seasonal characteristics from 2016 to 2021 in Jinshan District, which predominantly occurred in Zhujing Town, Shanyang Town and Tinglin Town, and kindergartens were the main places.

Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.