Patients in Orthopedics have different psychological features in the stages of before treatment,the stage of treatment,the stage of rehabilitation and the stage of post-discharge.The health care workers should use language and non-verbal skills to communicate with patients according to their psychological characteristics,and adopt different communication skills with different individuals.A good communication not only reduces the disputes between doctors and patients,but also promotes physiologic and psychological rehabilitation.

[Objective]To investigate the characteristics,treatment and prognosis of tibial plateau fracture of Schatzker type Ⅴ and Ⅵ and recommend the option of the surgical treatment.[Method]From May 2002 to March 2006,arthroscopically assisted double-plating fixation,locking plate with cannulated screws and external fixation with limited internal fixation were performed in 35 patients with tibial plateau fracture of Schatzker Ⅴ and Ⅵ.[Result]All patients were followed up from 12 to 35 months with an average time of 16.5 months.Bone union was achieved in all cases.According to Rasmussen's functional grading system,the excellent,good,fair and poor cases were 19,10,4 and 2,respectively.[Conclusion]CT 3D reconstruction,evaluation of soft tissues injury,suitable operation timing and approaches,anatomical reduction,bone transplantation,proper fixation and right rehabilitation training are all key factors to improve the therapeutic effects on tibial plateau fracture of Schatzker Ⅴ and Ⅵ.

Objective To investigate the effect and hematopoietic reconstitution as well as survival of diffierent kinds of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in the treatment of leukemia.Methods allo-HSCT was used to treat 20 cases of leukemia from March 2003 to July 2006 in my hospital.Twelve of them received allo-PBSCT from HLA matched sibling donors.Four of them received HLA-mismatched unrelated umbilical cord blood transplantation.Three of them received allo-PBSCT from unrelated donors.One of them received bone marrow transplantion from unrelated donors.Results Totally 19 recipients acheived hematopoietic reconstitution.The median time of hematopoietic reconstitution after UCBT was longer than that of HLA matched sibling PBSCT.Seven patients received aGVHD after allo-HSCT,and 4 among them were Ⅰ~Ⅱ degree and 3 cases Ⅲ~Ⅳ degree.Two patients died of relapse,and 3 patients died of GVHD.One patient was puzzled by cGVHD.The others are disease-free survival now.The median time of survival is 30(1~41)months.Conclusion allo-HSCT is effective for the cure of patients with leukemia.UCBT with enough cells and 1~2 mismatched loci is safe and effective for the patients who have no HLA matched sibling donors.

0.05). In bone defects PeroGlas granales bond to bone and new bone formation were observed 4 weeks after operation. The bone defects were repa ired by new bone 12 weeks after PerioGlas implantation. Conclusion: PerioGlas may induce new bone formation in osseous defects.

BACKGROUND:As the epiphyseal plate has an important role in the growth and development of femur, the design of internal fixation should avoid the damage to the epiphyseal plate. Therefore, the positioning of pediatric femoral epiphyseal plate is particularly important.
OBJECTIVE:To investigate the biomechanical property of the new femur neck screw internal fixation in treatment of children femoral neck fracture.
METHODS:Twelve femurs were col ected from six fresh children cadavers provided by Dissecting Room of University of South China. After exclusion of bone disease with X-ray film, three new children femoral neck screws and three Kirschner wires with the diameter of 2.0 mm were used for fixation. The biomechanical tests were conducted to detect the axial compression and torsion stiffness.
RESULTS AND CONCLUSION:In the children femoral neck screw group, the axial compression stiffness and torsion stiffness under the torsional torque of maximum 3 N?m were (190.74±20.88) N/mm and (0.18±0.045) N?m/° respectively;(138.95±15.19) N/mm and (0.120±0.036) N?m/° respectively in the Kirschner wire group;there were significant differences in the axial compression stiffness and torsion stiffness between two groups (P<0.05). The results showed that the compressive strength and torsional capacity of the children femoral neck screw were strong than those of Kirschner wire. The experiment suggested that the femoral neck screw for children is a new type of ideal internal fixation device which consist with the anatomical features of children proximal femur and can meet the requirement of children femoral neck fracture with good biomechanical property.

Objective To investigate the causes and treatment strategies of spinal multidrug-resistance tuberculosis.Methods Data of 16 patients with spinal multidrug-resistance tuberculosis from Jane 2007 to September 2012 were retrospectively analyzed.There were 12 males and 4 females,with an average age of 26.6 years (range,10-49 years).The 16 patients involved 44 vertebrae,with an average of 2.75 vertebrae.The involved segments included:9 thoracic segments,1 thoracic-lumbar segment,2 lumbar segments and 3 lumbar-sacral segments.1 patient involved jumping segments including T8.9,T12L1.Among them,5 suffered from pulmonary tuberculosis,4 tuberculous pleurisy,3 tuberculous empyema,1 tuberculosis of cervical lymph nodes,1 tuberculosis of sternum,1 tuberculosis of chest wall and 1 nephrotic syndrome.We analyzed the reasons of multidrug-resistance.All patients received individualized chemotherapy based on drug sensitivity test.The operation process and time were also collected.The treatment effects were determined by long-term follow-up.Results Among all the 16 patients,6 received 1 operation; 7 received 2 operations; 2 received 3 operations and the last operation was one-stage posterior instrumentation and anterior debridement,bone grafting which conducted in our hospital; 1 received 4 operations and the last of which was excision of sinus in our hospital.All patients were followed up for 10 to 60 months (average,28.4 months).The time of chemotherapy which accorded to the drug sensitivity test was 24 months.2 cases recurred after 22 months and 46 months of the 1st surgery and received operation again.At the last follow-up,all patients were in a stable state of tuberculosis.In 16 patients,2 were initial drug resistance and 14 were acquired drug resistance.The causes of acquired drug resistance were multiple organs tuberculosis caused by failure chemotherapy,times of failed surgeries without adjusted schedules,suspension of the anti-tuberculosis chemotherapy due to serious adverse drug reactions and so on.Conclusion It is very important to carry through the culture of tubercle bacillus and acquire the results of drug sensitive test earlier.The key to prevent and cure multidrug-resistant tuberculosis of spine are formulating individualized anti-tuberculosis chemotherapy program,monitoring closely the adverse drug reactions and selecting the appropriate time for surgery.

AIM:The different factors on stability of salvianolic acid B in Danshen freeze-dried powder injection was investigated to provide the experimental data for clinical application and storage of the preparation. METHODS: The stability of salvianolic acid B for lamplight,temperature,sodium chloride injection and glucose injection in Danshen freeze-dried powder injection were studied and the content of salvianolic acid B was determined by HPLC. RESULTS: The content of salvianolic acid B in Danshen freeze-dried powder injection didn't almost change under the condition of lamplight(3000lx) in 60 d.Its expiry date estimated by Q_(10) method was(2.39) a.The preparation was matched respectively with(0.9%) sodium chloride injection and 5% glucose injection,the content of salvianolic acid B was invariable and insoluble particles were qualified under the condition of 25 and 37 ℃ in 24 h. CONCLUSION: Danshen freeze-dried powder injection is stable for lamplight and clinical injection and the expiry data of the preparation is(2.39) a.

Objective To study the inhibitory effect of arsenic trioxide(AS2O3)on the tumor growth of breast cancer line MDA-MB-435s implanted subcutaneously in nude mice and its mechanism.Methods BALB/C-nu/nu nude mice were subcutaneously injected with MDA-MB-435s breast cancer cells that are ER-positive,and treated with intraperitoneal injection of AS2O3 and DDP in different concentrations.The implanted tumor was weighed,and tumor inhibition rates were calculated.The expression of PTEN and Caspase-7 induced by AS2 03 were examined by immunohistochemical method.Results The growth of implanted tumor was markedly inhibited with DDP,low dose and high dose AS2O3,and the inhibitory rates were 48.68%,32.80%,66.67%respectively.The immunohisto chemical staining showed that the number of PTEN and Caspase-7 protein increased markedly(P＜0.05).Conclu sions AS2O3 inhibits the growth of human breast cancer cell implanted tumor.The molecular mechanism of AS2O3 on induction of apoptosis of breast cancer cells may be throush increasing the expression of PrrEN and Caspase-7(P ＜0.05).

Aim To study the effect of polysaccharides from Gastrodia elata Blume(GEP) on levels of superoxide dismutase(SOD),malondialdehyde(MDA) and nitric oxide(NO);and the retinal morphology after rat retina ischemia reperfusion injury.Method Retinal ischemia was induced in SD rats by increasing the intraocular pressure to 16 kPa for 60 min via cannulation into the anterior chamber.SD rats were divided into five groups randomly: Small dose GEP group,Middle dose GEP group,Large dose GEP group,Vitamin E group and Negative contral group.At 60 min,24 h and 72 h after ischemia reperfusion,levels of SOD,MDA and NO in rat retinas were measured,and histopathologic changes were observed.Results At 60 min,24 h and 72 h after ischemia reperfusion,levels of SOD in rat retinas in middle,large dose GEP groups were significantly higher than that in negative control group(P

Objective To study the profile of peripheral blood cortisol concentration in patients with hepatitis B virus (HBV)-related acute on chronic liver failure (ACLF) and its association with disease severity and predictive value on prognosis.Methods Forty-five patients with HBV-related ACLF,including 15 patients in early-stage,15 in medium stage and 15 in end-stage; and 15 patients with severe chronic hepatitis B (CHB) were also enrolled.Peripheral blood cortisol concentration was tested by chemiluminesence immunoassay.SPSS version 18.0 was used to compare peripheral blood cortisol concentration among different groups and analyze its correlation with prothrombin activity (PTA),total bilirubin (TBil),albumin (Alb),alanine aminotransferase (ALT),aspartate aminotransferase (AST),HBV DNA,international normalized ratio (INR) and model for end-stage liver disease (MELD) scores.The independent risk factors of prognosis in patients with HBV-related ACLF were determined by performing Logistic regression analysis.Results The concentrations of peripheral blood cortisol in severe CHB group,early stage ACLF group,medium stage ACLF group and end-stage ACLF group were (595.6±114.0),(496.0±87.2),(303.9±81.1),and (183.8±71.8) nmol/L,respectively.A decreasing trend was observed and the differences among groups were statistically significant (F =63.93,P ＜ 0.01).Peripheral blood cortisol concentration were significantly different among subgroups of patients with MELD＜30,followed by 30-40 and ＞40(F 9.01,P＜0.01).Peripheral blood cortisol concentration in patients with ACLF was positively correlated with PTA level (r=0.83,P＜0.01),and inversely correlated with TBil (r =-0.34,P＜0.05),MELDscore (r =-0.60,P＜0.01),AST/ALT (r =-0.35,P＜0.05),and INR (r=-0.59,P＜0.01).Association with Alb,ALT,AST and HBV DNA was not observed.According to multivariate Logistic regression analysis,MELD score,cortisol level,Alb and total cholesterol were independent risk factors of prognosis for patients with ACLF.Serum cortisol concentration in survival group of HBV-related ACLF was higher than that in death group,while the death group exhibited a gradually decreasing trend.Conclusions The peripheral blood cortisol concentration decreases in patients with HBV-related ACLF,which is related to the degree of liver dysfunction,disease severity and prognosis of patients.Moreover,the lower level of cortisol concentration indicates poor short-term prognosis in patients with HBV related ACLF.