1.15).It had marked difference between the combined group and the ADM group alone(P

Objective To analyse the causes of non-union and delayed union in distal femur and assess the clinical outcomes of retrograde intramedullary interlocking nail(RIIN). Methods Between June 1995 and December 1998, 15 cases of non-union and delayed union of distal femur were treated with RIIN. There were 9 males and 6 females, the average age of the patients was 34.5 years(range 23 to 46 years). At surgery, the failed implants were removed in all 15 cases, bone graft was performed in 10 cases, closed reaming was done in 5 cases. 11 patients also received knee adhesion release operation. The X-ray examination and KSS knee functional score were used to evaluate the results. Results The average duration of follow-up was 14.5 months. All patients achieved solid bone union at an average of 6.4 months. There were no malunion, infection and refracture in this series. According to the KSS rating system, the average range of motion(ROM) was 93.5 degrees, increased by 28 degrees(42.7％ ) compared with the preoperation ROM. The average knee score was 96 points. The excellent result was obtained in 13 cases, good in 2 cases. The average knee function score was 90.5 points. Conclusion The main reasons for non-union and delayed union were improper selection of the indications and use of implants. Retrograde intramedullary interlocking nail is one of the effective alteratives for treatment of distal femur non-union and delayed union. It can provide a stable and reliable fixation which is of benefit for early functional exercise. Bone grafting, closed reaming technique and knee joint adhesion release should be considered in order to enhance the bone healing and the improvement of knee ROM and function.

Objective To study the antiviral and antibacterial effects of the effective site of traditional Chinese medicine(TCM-ES).Methods Chicken embryoes were infected with influenza virus A(FM1 strain) and pre-injected with TCM-ES by means of chicken-embryo inoculation technique,and the antiviral effect of TCM-ES on chicken embryo was assayed by detecting the hemagglutination titers in allantoic fluids.Mice were orally pretreated with various dosages of drugs twice daily for 3 days,then were given drugs continuously for another 4 days following FM1 infection.The protective effects of TCM-ES on mice infected with FM1 were assayed by calculating the weight,index of lung,death-protection rate,and life-prolongation rate,etc.Ribavirin was used as the positive control.In addition,the antibacterial effects of TCM-ES were observed by detecting the minimum inhibitory concentration(MIC) and minimum bactericidal concentration(MBC) by test-tube dilution method.Results In chicken embryo experiments,TCM-ES showed a potential inhibiting effect on influenza virus with the MIC of 10 mg/mL,which was weaker than ribavirin.The results of animal experiment showed that the body-weight(BW) and pulmonary index of infected model group decreased evidently compared with those of the normal group,TCM-ES groups at the dosages of 750 mg/kg and 1500 mg/kg could reverse the decrease of BW and lung index as compared with the infected models,the difference being insignificant as compared with the normal group.Moreover,TCM-ES also increased the death-protection rate and life-prolongation rate of mice in a dose-dependent manner.TCM-ES at dosage of 10 mg/mL(MIC and MBC) had an antibacterial effect on staphylococcus,while had no effect on gram-negative bacilli.Conclusion TCM-ES has obvious antivirus effect on influenza virus FM1 strain,and also has certain antibacterial effect on staphylococcus,which is worth of further development and research.

Objective To evaluate the efficacy of myringotomy with grommet insertion in the treatment of tympanic membrane atelectasis .Methods From July 2011 to July 2013 ,62 patient with tympanic membrane atelecta-sis were treated with myringotomy with grommet insertion in our hospital ,we evaluated 54 patients(56 ears)whose follow -up period was 1 year or more .Of the 54 patients included in this study ,28 (30 ears))were female and 26(26 ears)were male .The age of the patients ranged from 8 to 54 ,with a mean age of 25 .8 ± 6 .6 years old ,and 18 pa-tients (32% ) were under the age of 16 .The air -bone gap(ABG)was compared at pre -operation and 1 year after post-operation .Results The average ABG of pre-operation and post -operation ,including all patients ,were 27 . 07 ± 5 .03 dB and 15 .52 ± 5 .73 dB ,respectively (P<0 .05) ,and the difference was statistically significant .All the 3 groups ,the ABG of pre- and post-operation ,the difference of each group was statistically significant .Conclusion Myringotomy with grommet insertion was effective in treating tympanic membrane atelectasis .

Objective To assess the differential diagnosis and characteristics of renal benign and malignant tumors with three-dimensional contrast-enhanced ultrasound (3D-CEUS). Methods Totally 68 patients with renal tumors were examined by conventional ultrasound and two-dimensional contrastenhanced ultrasound(2D-CEUS). 3D imaging was reconstructed from 2D imaging, the differential diagnosis of renal tumors with 3D-CEUS was analyzed by comparing with 2D-CEUS. All patients with renal tumors were proved by operational pathology. Results Eighteen patients with renal benign tumors mostly displayed equal or low enhancement, showed "slowly in and slowly out" with 2D-CEUS, while displayed regular peripheral and internal vessels with 3D-CEUS. Fifty patients with renal malignant tumors mostly displayed high enhancement, showed "rapidly in and rapidly out" with 2D-CEUS,displayed winding peripheral vessels and disordered internal vessels with 3D-CEUS. 3D-CEUS may display the vascular characteristics of tumors and showed superior imaging quality to 2D-CEUS ( P ＜ 0.05). Conclusions 3D-CEUS can display the vascular characteristics of tumors and their spatial positions, it plays an important role in differential diagnosis between renal benign and malignant tumors.

Objective To describe and explore the practice of eye care in ICU,in order to make a specified training plan and guideline on eye care,and to improve the skill in eye care of ICU nurses. Methods A survey was conducted in 92 ICU nurses from 2 general hospitals in Huizhou city with non-random sampling using a self- made questionnaire to investigate their eye care of patients. Results The nursing practice of eye care in ICU was urged to be improved,there was no standard on eye care. Conclusions The knowledge of ICU nurses needs to be enhanced,and guideline on eye care is urged to be worked out,so that practice of eye care would be improved.

Objective To explore the value of contrast-enhanced ultrasound(CEUS) in the diagnosis of hematoma and active hemorrhage of renal trauma. Methods Totally 28 patients with renal trauma were examined by conventional ultrasound and CEUS,respectively,including 24 cases caused after renal biopsy,4closed trauma. The detectability of renal hematoma and active hemorrhage with these two methods were compared. All patients were identified by CT or follow-up studies with ultrasound. Results The detectability of renal hematoma with conventional ultrasound and CEUS were 67. 86% (19/28), 92. 86%(26/28), respectively. There was statistically different for detectability in the diagnosis ( P ＜0.05), and the extent of hematoma was more obvious with CEUS. CEUS diagnosed 7 of 26 were renal hematoma with active hemorrhage,which were difficult to be detected with conventional ultrasound. For renal hematoma,the features of CEUS were no enhancement found in every phase; for renal hematoma with active hemorrhage,the contrast agents overflowed from injured blood vessels and formed irregular remarkable enhanced regions. Conclusions CEUS is useful in diagnosing hematoma and identifying the extent and active hemorrhage of renal trauma,in addition,CEUS is valuable in detecting complications after renal biopsy.

Objective To compare the therapeutic effect of conventional treatment and conventional treatment plus external application of Shuangbai Powder for patients with wounded limb injured by venomous snake. Methods One hundred patients bitten by venomous snake were randomized into treatment group and control group, 50 cases in each group. The control group was given conventional treatment including repeatedly washing the wound with hydrogen peroxide, debriding the wound, letting blood and draining toxicity, local blocking with chymotrypsin, wet packing the wounded limb with magnesium sulfate, and injection with anti-venomous serum, tetanus antitoxin, antibiotics, furosemide and energy mixture. The treatment group was given external application of Shuangbai Powder on the basis of the treatment for the control group. Both groups were given the comprehensive nursing of psychological nursing, wound nursing, dietary nursing, defecation nursing and functional nursing. The swelling-subsiding time for the wounded limb and pain scores of visual analogue scale (VAS) in the two groups were compared. Results(1) After treatment, swelling-subsiding time for the wounded limb of the treatment group was shorter than that of the control group, the difference being statistically significant (P < 0.05). (2) After treatment for 4 days and at the end of the treatment, VAS scores of the two groups were decreased compared with those before treatment(P < 0.05), and the decrease of VAS scores in the treatment group after treatment for 4 days was superior to that in the control group (P < 0.05). Conclusion The conventional treatment plus external application of Shuangbai Powder is an effective therapy for patients with wounded limb injured by venomous snake by shortening swelling-subsiding time and relieving pain for the wounded limb .

A simple and reliable electroanalytical method for the fast determination of aluminum in natural and drinking waters by a. c. oscillopolarography using solochrome violet RS(SVRS) is described. The alkaline buffer solution used was 0.85 mol/L NH3·H2O- NH4 Cl(pH 8.8) containing 5 × 10-5 mol/L SVRS. A sensitive incision due to the redox reaction of Al-SVRS complex adsorption wave on the Hg-film electrode was observed on the dE/dtE oscillogram at - 1.05 V. The incision depth was linearly proportional to the A1 concentration in the range of 1 ×10-7 ～6 × 10-6 mol/L. No serious interference was found. The detection limit of this method was 5 × 10-8 mol/L,and the relative standard deviation was 5.5% for 2 × 10-7 mol/L Al ( n = 10). This method was successfully applied to the determination Al in 22 real samples. The results were found to be in good agreement with those obtained by inductively coupled plasma-atomic emission spectrometry.

Objective To investigate the effect of Roux-en-Y gastric bypass surgery on renal gluconeogenesis, and to explore the mechanism of improving glucose control and insulin sensitivity in obese rats.Methods Rats were randomly divided into the obese group (n=30) consumed high-fat diet (HFD) and control group (NC group, n=8).Top 24 of animals fed HFD by change in body mass were subdivided into three groups: obese control group (OB group, n=8), obese under RYGB group (RYGB group, n=8) or sham-operation (sham group, n=8).Intraperitoneal glucose tolerance tests (IPGTT) were performed meanwhile the AUC of blood glucose concentration-time after surgery.Fasting glucose, insulin and lipid were measured respectively and HOMA-IR were calculated.The mRNA level and protein level of the key enzymes (G6P and PEPCK) of renal gluconeogenesis were examined with RT-PCR and Western blot respectively.Results Compared with OB group and Sham group, the body mass, lipid, blood glucose, insulin, HOMA-IR and AUG were significantly decreased (P<0.05), the expression of G6P and PEPCK mRNA and protein were significantly reduced(P<0.05) in RYGBgroup.Conclusions Roux-en-Y gastric bypass surgery can improve glucose control and insulin resistance, which may be related to the decreased level of mRNA, protein of G6P and PEPCK, reduced gluconeogenesis and glucose output in renal cortex.