[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 explore the relation between puncturing at superficial venules and effectiveness of acupoint application in summer to treat winter disease. Methods 4872 chronic bronchitis patients who received therapy of acupoint application in summer for treating winter diseases were divided into a superficial-venule group (including 994 patients) and a non-superficial-venuls group (including 3878 patients), according to the conditions that if or not they had superficial venuls. Both groups received the treatment of acupoint application combined with plum-blossom needles quick puncture. On this basis, the superficial-venule group was additional treated by puncturing at superficial venules. Results The cure rate and total effective rate were 73.2% and 98.1% in the superficial-venule group, and 35.9% and 90.8% in the non-superficial-venuls group. There was a significant difference between the two groups in their therapeutic effect (P＜0.01).Conclusion The treatment of acupoint application combined with puncturing at superficial venules are effective in treating chronic bronchitis.

Objective To study the complications and their management of plasmakinetic transurethral resection of the prostate (PKRP). Methods Complications and their management of 51 cases of PKRP from May 2003 to June 2006 were retrospectively reviewed. Results Complications of the procedure were as follows. Bladder spasms occurred in 27 cases (accompanying hemorrhage in 2 cases and urge incontinence in 6 cases), and the symptoms disappeared after patient-controlled intravenous analgesia and M-receptor blocker (tolterodine). Postoperative bleeding occurred in 6 cases. Continuous irrigation with normal saline and medical therapy were given in 3 cases, and open surgery was required in 3 cases with severe bleeding. All bleeding patients obtained a full recovery of voiding function without re-bleeding. Urge incontinence occurred in 13 cases, and was cured with functional exercises of pelvic floor muscles and M-receptor blocker (tolterodine) administration. Stress incontinence was observed in 1 case, and a penile clamp had been used to control incontinence. Among 7 cases of urinary retention after operation, a re-operation of PKRP was conducted in 2 cases and oral medication was carried out in 5. The voiding function recovered well in all the 7 cases. In 5 cases of urethral stricture, urethral dilatation was employed in 3 cases and urethrotomy was performed in 2 cases to obtain a good recovery of voiding function. Conclusions Bladder spasm, postoperative bleeding, incontinence, urinary retention, and urethral stricture are common complications of PKRP. Strict adherence to technique and timely and proper management of complications are considered essential to improve results.

[Objective]To analyze the results of distal tibial pilon fractures treated with individual management based on severity of soft tissue injury.[Method]From January 2005 to September 2008,29 Pilon fractures were treated.There were 22 males and 7 females aging from 23 to 63,with an average of 41.4.According to Ruedi-Allgower classification system of Pilon fracture,16 cases were type Ⅱ,13 type Ⅲ.According to Tscherne-Gotzen graduation system of soft tissue injury,22 cases were close fracture,8 grade 0,4 grade 1,8 grade 2,2 grade 3,and 7 cases were open fracture,3 grade 1,2 grade 2,2 grade 3.Individual management was based on severity of soft tissue injury.[Result]All patients were available for follow-up at an average of 28.6 months(range,12 to 56 months) after surgery.There were 10 excellent,13 good,4 fair,and 2 poor results according to the ankle score of Mazur.The complications occurred in 5 patients(17.2%),including wound superficial infection(n=2),skin necrosis(n=1),deep infection(n=1),and pin tract infection(n=1) with external fixation.[Conclusion]Individual management based on severity of soft tissue injury for Pilon fracture has advantages of fewer complications and good function.

In this paper, a remote monitoring system based on three tiers framework of ″Home-Community-Hospital″ for home monitoring is introduced. Its characteristics include multiuser concurrency operation, multiple testing parameter, real-time interactivity, dependable and secure data communication, high-speed link with database and load balancing. According to user's requirements, various applications can be developed to perfect medical information system based on B/S mode. A portable multiparametric tester based on embedded system has the functions of wireless data transmission and network communication, whose hardware and software designs are modularized.

Objective To investigate the serum levels of procalcitomn (PCT) and high mobility group box chromosomal protein-1 ( HMGB1 ) in patients with acute pancreatitis (AP) ; and study the relationship between the serum levels of PCT,HMGB1 and the severity and prognosis of AP.Methods The blood samples were collected from 80 AP patients,including 38 severe acute pancreatitis (SAP) patients and 42 mild acute pancreatitis (MAP) patients.The serum levels of HMGB1 were measured by ELISA kit,and the levels of PCT were measured by immunoassay chemiluminescent technique,then their relationship with other biochemical parameters,the severity and prognosis of AP was analyzed.30 healthy adults were treated as the control group.Results The serum PCT and HMGB1 levels were ( 8.18 ± 3.24) μg/L and ( 11.79 ± 3.98 ) μg/L in SAP group,and the corresponding values were (5.67 ± 2.43) μg/L and ( 5.38 ± 2.06) μg/L in MAP group,and both were significantly higher than those in control group [ ( 1.85 ± 0.86) μg/L and ( 1.87 ± 1.47) μg/L,P ＜0.01 ].The serum level of PCT was positively correlated with serum 1evel of HMGB1 ( r =0.276,P =0.014),and both were positively correlated with Ranson score,APACHE Ⅱ score,Balthazar CT score (P＜0.05 or ＜0.01 ).The HMGB1 levels were significantly higher in patients with organ dysfunction than those in patients without organ dysfunction (P ＜0.05).Conclusions In AP patients,serum PCT and HMGB1 levels were significantly increased,and they were positively correlated with disease severity.These results suggest that PCT and HMGB1 may act as potential serum markers for AP severity evaluation.

Objective (1) To investigate the glucose and lipid metabolism 6-12 weeks after delivery in women with hyperglycemia during pregnancy. (2) To find out factors associated with the prognosis of women with hyperglycemia during pregnancy. (3) To investigate the feasibility of the diagnostic criteria set by the International Association of Diabetes and Pregnancy Study Group according to the follow-up data of women with hyperglycemia in pregnancy. Methods Clinical data of 262 women with hyperglycemia during pregnancy delivered in our hospital from January 1, 2007 to December 31, 2009 were collected. All patients underwent oral glucose tolerance test (OGTT) at 6-12weeks after delivery. They were divided into two groups according to the postnatal status of glucose and lipid metabolism. Multivariate Logistic regression model was used to analyze the factors affected glucose and lipid metabolism after 6-12 weeks of delivery. Results (1) Among the 262 women, 92(35.1%) were reported with abnormal glucose metabolism at 6-12 weeks of delivery, including one (0. 4 % ) woman with impaired fasting glucose, 81 (30. 9 % ) with impaired glucose tolerance, 4( 1.5 % )with impaired fasting glucose+impaired glucose tolerance and 6 (2. 3%) with diabetes mellitus.glucose levels in OGTT (OGTT 2hPG and the OGTT 3hPG) were risk factors for postpartum 0. 181-0. 918)]. (3) All markers of lipid metabolism were detected in 250 women with hyperglycemia during pregnancy at 6-12 weeks after delivery, the rate of abnormal postnatal lipid metabolism was 63.2%(158/250). In the abnormal group (n= 174), the most common abnormal marker was hypercholesterolemia (n = 126, 50. 4 % ), followed by high levels of low-density lipoprotein-cholesterol (n = 102, 40. 8 %), hypertriglyceridemia (n= 60, 24. 0 %) and low levels of high-density lipoproteincholesterol (n= 11, 4. 4 %). (4) Logistic regression model showed that elevated OGTT 2hPG was the risk factor for postpartum abnormal glucose metabolism [OR= 1. 364 (95%CI: 1. 063-1. 751)], while 0. 169-0. 851)]. Conclusions Women with hyperglycemia during pregnancy are more likely to present with abnormal glucose and lipid metabolism which commonly coexisted with insulin resistance.The risk factors for the postpartum abnormal glucose metabolism in mothers with hyperglycemia during pregnancy include early diagnosis, OGTT 2hPG and OGTT 3hPG, while the protective factor is breastfeeding. The risk factor for the postpartum dyslipidaemia in mothers with hyperglycemia during pregnancy is OGTT 2hPG, while the protective factor is high-density lipoprotein-cholesterol level in pregnancy.

This study was aimed to offer a scientific basis for the differentiation and control quality of Castanea mol-lissima Blume shell. The determination was given from the morphological identification, microscopical identification and TLC identification. The results showed that through obtained information such as morphological traits, tissue powder and TLC characteristics, the longitudinal section micrographs of C. mollissima Blume shell and the micro-scopic images of tissue powder had been received. It was concluded that the study provided a reliable reference for the identification of the quality control standards of C. mollissima Blume shell.

Objective To analyze the implementation effect of formative assessment in nutri-tion and food hygiene. Methods 55 students of Class One from grade 2010 majoring in preventive medicine were taken as the control group, with 56 students of Class Two as the experimental group.The control group used the summative assessment , while the experimental group used the formative assessment. Results were analyzed by course examinations and questionnaire surveys. SPSS 17.0 soft-ware was used and the measurement data were expressed by x±s. Statistical analysis was performed using t test, test, rank sum test, a Yuan linear correlation analysis, with the level of test α=0.05. Results The experimental scores and final scores of experimental group students were significantly higher than the control group and the difference was statistically significant(P values were 0.001, 0.000). The experimental group's overall result is closer to the negative skewed distribution. The ex-perimental group's average score of 89 points is significantly higher than the control group's average score of 79 points(P<0.01), and the usual results and the final results were positively correlated(r=0.865, P<0.001). The survey indicated that the students recognized the application of formative assess-ment in teaching process . Conclusion Formative assessment can help improve the teaching and learning quality in nutrition and food hygiene.

Objective To investigate the outcomes of increased gestational diabetes mellitus (GDM) and the influencing factors after the implementation of the new GDM diagnostic criteria.Methods A total of 1 439 GDM women who delivered in the Peking University First Hospital between May 1,2011 and December 31,2012 were studied and divided into two groups.Group Ⅰ included the women who met the new GDM diagnostic criteria (fasting plasma glucose and 1 or 2 h plasma glucose levels for 75-g oral glucose tolerance test performed between 24 and 28 weeks of gestation were no less than 5.1,10.0 and 8.5 mmol/L),but did not meet the National Diabetes Data Group (NDDG) criteria;and Group Ⅱ included the women who met the NDDG criteria only.Women in Group Ⅰ were further divided into two subgroups according to whether attending the one-day GDM outpatient visit.Follow-up rate and detecting rate of abnormal glucose metabolism at 6-12 weeks after delivery were analyzed.Chi-square test,t test and multivariate Logistic analysis were used for statistical analysis.Results There were 849 GDM women in Group Ⅰ (59.0％,849/1 439) and 590 (41.0％,590/1 439) in Group Ⅱ.The follow-up rate in group Ⅰ was lower than in group Ⅱ [25.9％(220/849) vs 32.0％(189/590),x2=6.112,P=0.013].There were five cases of impaired fasting glucose and 34 impaired glucose tolerance in Group Ⅰ;and four cases of impaired fasting glucose,56 impaired glucose tolerance,eight impaired fasting glucose tolerance with impaired glucose tolerance and five diabetes mellitus in Group Ⅱ;there were significant differences [17.7％(39/220) vs 38.6％(73/189),x2=33.810,P=0.000].(2) In Group Ⅰ,the increased glucose level at 2 h in oral glucose tolerance test during pregnancy (OR=1.547,95％CI:1.038-2.306,P=0.032) and family history of diabetes mellitus (OR=1.879,95％CI:1.066-3.313,P=0.020) were risk factors for postpartum abnormal glucose metabolism,while breast-feeding was a protective factor (OR=0.290,95％CI:0.092-0.914,P=0.035).(3) In group Ⅰ,the follow-up rate in those who attended the one-day GDM outpatient visit was higher than those who did not [30.7％(185/603) vs 14.2％(35/246),x2=23.780,P=0.000],but the detecting rate of postpartum abnormal glucose metabolism were similar in women attending the one-day GDM outpatient visit and those not attending [17.8％(33/185) vs 17.1％(6/35),x2=0.020,P=0.887].Conclusions Increased GDM women still have glucose metabolism abnormality after delivery,especially those who have higher glucose level at 2 h after glucose intake in 75 g oral glucose tolerance test during pregnancy and who have a family history of diabetes mellitus.The one day GDM outpatient visit may improve the follow-up rate for these women.