[Objective]To explore the treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation.[Method]From February 2001 to August 2005,21cases of acute Lisfranc fracture-dislocations were treated with open reduction and cannulated screw fixation.[Result] According to the AOFAS for mid foot,1 case scored 70 to 80,3 cases scored 80 to 90 and 17 cases scored 90 to 100.[Conclusion]Treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation in early stage can lead to satisfactory reduction and clinical results,it is a satisfying method.

Objective To explore the pathogenesis of acute lung injury in rats suffering hemorrhagic shock at plateau.Methods Seventy-two male Wistar rats, weighing 280-320 g, were randomized into 6 groups (n=12): sham group (group Sham), hemorrhagic shock for 15 min (group HS15), hemorrhagic shock for 30 min group (group HS30), hemorrhagic shock for 45 min group (group HS45), hemorrhagic shock for 60 min group (group HS60) and 90 min group (group HS90).Hemorrhagic shock model of Wistar rats was reproduced at plateau.The rats were only anesthetized, no shock and were sacrificed after 90 min in group Sham.The other groups were different in bleeding time and then were respectively sacrificed at 15, 30, 45, 60 and 90 min after shock.The pathological changes in the lungs were observed with light microscope.Wet to dry weight ratio (W/D), lung permeability index (LPI), myeloperoxidase (MPO) activity, malondialdehyde (MDA) and superoxide dismutase (SOD) in lung were measured.Enzyme-linked immunosorbent assay was used to detect the TNF-α and IL-10 in lung tissue, the expression and distribution of claudin-3 and claudin-4 in lung tissue was verified by immunohistochemistry method.Results Compared with group Sham, shock causes acute lung injury at different degree, and was positively correlated with the duration of shock, during the period of 15 to 30 min, it merely rendered a slight change in lung W/D, LPI, MPO, MDA, TNF-α, T-SOD and IL-10.Subsequently, along with time prolonged, lung W/D, neutrophils in BALF, LPI, MPO, MDA, TNF-α were significantly elevated, while T-SOD and IL-10 were notably reduced (P<0.05).Immunohistochemical results showed that claudin-3 and claudin-4 expression in lung epithelial cells and endothelial cells expressed at low levels and dislocated (P<0.05).Conclusion After a short time compensatory lesions, the change of rats' hemodynamic stability suffering severe hemorrhagic shock showed a spiral downward.Along with the extension of the shock, hemorrhagic shock at plateau results into the disturbance of inflammatory response and oxidative stress, the loss of claudin-3 and claudin-4 in lung epithelial cells, which triggers the acute lung injury.

Objective To explore the influence of the intimacy and adaptability to the other fa- mily members on the postpartum recovery of parturients. Methods One hundred and twenty-two pregnant women were randomly selected among all the admissions from March to August of 2004 in the hospital. FACESⅡ-CV and (EPDS) were applied in this study. Results Postpartum depression and postpartum recovery were significantly correlated with the degree of intimacy and adaptability between the mother and other family members. Conclusions A higher degree of intimacy and adaptability in the family is helpful in postpartum recovery, breast-feeding and alleviating symptoms of postpartum depression.

Recently,wide application of MRI in clinic accelerates researches into the etiology,diagnosis,treatment and prognosis of bone bruises.MRI manifestations of bone bruises include trabecular microfracture associated with hemorrhage,oedema of subchondral bone because of direct or indirect traumatic force and focal abnormalities in subchondral bone of the knee.This condition is also known as occult injury of the knee,because it is likely to be overlooked or misdiagnosed in hospital due to its diagnostic difficulty by plain radiographs and CT.If timely intervention is not given,it will be accompanied by chronic pain which seriously affects the daily life of the patients,even resulting in early degeneration.This article discusses the current research on bone bruises of the knee.

The Qirongrunchang Mixture(QRRCM)is a prescription composed of Radix Astragali,Fructus Cannabis,etc.It is effective for habitual constipa- tion and constipation in the aged and the debilitated,It was shown in this study that oral administration of this mixture could accelerate the intestinal movement in mice with yang-deficiency in a dose-dependent manner,and exerted a cathartic effect on mice with eonstipation.It increased the volume of intestinal content in rabbits,but did not influence the absorption of water in the intestines.

Medical science have two sides in its nature. It is not only a subject of science, but also a social science. Medical science need social science to nourish it. At present, unsuitable language is the main cause which lead to medical tangles. The medical workers' attitude towards patients is the key factor during the solving course. Most of the medical tangles do not lead to accusing in the beginning. Both patients and the hospital wish to solve the tangle by intercession or compromise instead of law ways. Appropriate language could avoid non-malpractice tangles. It also play an important role in solving the medical tangles.

Objective Explore reflux esophagitis age,symptoms,and the relationship between the degree of esophageal damage.Methods Summing up 198 cases of young and middle-aged patients and 104 cases of elderly pa-tients with the symptom score and Endoscopic mucosal injurs classification.Results Under the old group gastroscopy serious esophagitis more than the young group,old age group was 49.97%,25.25%for the young group,but the clini-cal symptoms of heart burn not obvious.Conclusion Reflux esophagitis damaged esophagus increased with age in-crease,but clinical heartburn symptoms do not necessarily obvious,it should attach importance to the brink throat dis-comfort,and other symptoms.

Objective To investigate the effect of electroacupuncture (EA) combined with repetitive transcranial magnetic stimulation ( rTMS) on postsynaptic density 95 ( PSD- 95) in the hippocampus of rats after cerebral ischemia. Methods Sixty healthy male Wistar rats were divided into normal, model, EA, rTMS and EA + rTMS groups randomly, and the rats in each group were further divided into 7 d, 14 d and 28 d subgroups. A model of middle cerebral artery occlusion ( MCAO) was established, followed by EA, rTMS or EA + rTMS treat-ment. The expression of PSD-95 in the dentate gyros and area CA3 of the hippocampus of the ischemic cerebral hemisphere were investigated. Results The expression of PSD-95 in the dentate gyrus and area CA3 of the ische-mic cerebral hemisphere had decreased 7 d after cerebral ischemia. The expression of PSD-95 in the three treat-ment groups increased after 14 d of treatment and was significantly greater compared with the model group after 28 d of treatment. The EA + rTMS group was especially superior to the EA and rTMS groups in terms of the expression of PSD-95 in area CA3 by the 28th day. Conclusions EA + rTMS can significantly increase the expression of PSD-95 in the hippocampus after cerebral ischemia. This may help explain how EA + rTMS improves learning and mem-ory after cerebral ischemia.

Background: Integrative traditional Chinese and western medicine may be a new approach to improve the eradication rate of Helicobacter pylori (Hp).Aims: To compare the efficacy and safety of Weifuchun tablet versus bismuth combined with standard triple regimen as the first-line therapy of Hp infection.Methods: A total of 141 patients with Hp infection and na(i)ve to treatment were randomly assigned into 3 groups receiving a 14-day eradication therapy.In standard triple therapy group, esomeprazole, amoxicillin and clarithromycin were given twice a day;while in Weifuchun group and bismuth group, Weifuchun tablet and bismuth potassium citrate were added, respectively, to the standard triple therapy.Hp eradication was assessed by 13C-urea breath test at least 6 weeks after the end of treatment.Hp isolates were tested for resistance to antibiotics.Results: One hundred and twenty-eight patients completed the study.Hp eradication rates in Weifuchun group, bismuth group and standard triple therapy group were 83.7%, 91.8% and 79.1%, respectively by ITT analysis and 88.4%, 97.8% and 84.6%, respectively by PP analysis.The eradication rate of Weifuchun group was lower than that of bismuth group and higher than that of standard triple therapy group, but the differences were not statistically significant (P>0.05).Only PP eradication rate of bismuth group was significantly higher than that of standard triple therapy group (P<0.05).The resistant rates of Hp to clarithromycin, amoxicillin and metronidazole were 33.3%, 2.9% and 70.5%, respectively.For eradication of clarithromycin resistant strains, bismuth group was superior to Weifuchun group and standard triple therapy group (100% vs.60.0% and 66.7%, P all <0.05).All three eradication regimens showed good compliance, and no significant difference in incidence of adverse events was found between the three regimens (P>0.05).Conclusions: Weifuchun tablet combined with standard triple regimen is safe and effective for use as first-line treatment for Hp infection, however, the eradication rate is relatively low in cases infected with clarithromycin resistant strains.Bismuth combined with standard triple regimen is a good alternative in areas with high clarithromycin resistance and regions where tetracycline is unavailable.