Leptin,the product of the obese gene,is a protein produced and secreted primarily by adipose tissue.Leptin initiates several biological effects by binding to its receptors.Many studies have shown that leptin can reduce fat accumulation,but its mechanism is still unclear.This article reviewed the effects of leptin on lipogenesis,and especially on proliferation and differentiation of preadipocytes.

Objective To evaluate the outcome of the old patients who were treated for femoral neck fractures in our hospital during 2000-2007. Methods A retrospective study was conducted to evaluate outcomes of the 139 old patients who had received internal fixation for femoral neck fractures in our department during 2000-2007. The mechanism of injury, duration between injury and hospitalization, severity of fracture, anamnesis, time of hospital stay, anaesthesia, operation, postoperative complications, fracture healing, in-cidence of avascular necrosis of femoral head, failure of fixation, and functional restoration of the patients were documented. Results Fracture healing was found in 126 cases (90.6%). Time to healing ranged from 2 to 20 months (average, 6.2 months). Failure of fixation and nonunion were found in 13 cases (9.4%). Avascular necrosis of femoral head occurred in 9 cases (6.5% ). Of them, 81 patients(58.3%) restored their gait as normal as before whereas 50 patients(36.0%) walked with crutches. Conclusions Internal fix-ation can be suggested for old patients with femoral neck fracture, considering a high rate of fracture healing and a low rate of avascular necrosis of the femoral head. Early operation is recommended if the general con-dition of the patient has been well controlled.

Objective To investigate how to prevent deep-vein thrombosis(DVT) after total knee replace-ment(TKR).Methods Deep vein thrombosis in 87 patients after TKR from 2004 to 2007 in the Third Hospital Affiliated to Suzhou University was retrospectively analyzed.Results Amony the 87 patients,13 were found having deep vein thrombosis,5 of 38 using low-molecular-weight beparin after TKR having deep vein thrombosis,6 of 35 cases using aspirin after TKR having deep vein thrombosis,5 of the 10 eases using mechanical preventive measures having deep vein thrombosis.The difference between low-molecular-weight heparin and aspirin group was not statistically significant.Conclusion Using low-molecular-weight heparin before TKR can prevent the occurrence of deep-vein thrombosis.Using epidural anesthesia,and a low-molee-ular-weight heparin drugs or aspirin after TKR can better prevent the formation of deep-vein thrombosis.

Objective To investigate the mechanism of acute patella bone cartilage fracture,and further study its diagnosis and treatment of clinical significance.Methods Collecting 21 cases of the acute patella bone cartilage fracture from July 2005 to December 2007.Eleven patients were male and ten were female,with the mean age of 31.6 (16～46) years.All the patients were treated using the arthroseopic microfracture technique after MR examination.Results All patients were followed up 6 to 18 months,did not show patellofemoral joint pain. Evaluated by Tagner rating,excellent outcomes were found in 17 cases,good in 4 cases,satisfactory results in 100% cases.Conclusion The arthroscopic microfracture technique in treatment of the patella cartilage fracture method is simple,easy to operate,can significantly improve knee function and pain,as well as the quality of life.

Objective: To present a modified method for harvesting and shaping fibular flap in reconstruction of mandibular defect. Methods: Fibula flap harvesting was performed under non-blood-evacuation of the donor limb and two gaps were made at the upper and lower ends of the fibular flap during the flap harvesting. Step-like osteotomy was performed to obtain 3 segments(each segment was 3~5 cm in length) of fibular bone. The shaping was achieved by fitting the bone segments together based on the natural contour of the mandible. The modified operation was conducted in 7 patients for mandibular reconstruction. Results:The method was successfully used in all patients with less bleeding during the flap harvesting and after reconstruction.The bone segments were rigidly fixed with good bony consolidation and contour. No complications occurred.Conclusion: The modified fibular flap harvesting method is feasible in mandible reconstruction.

Objective Tc explore the value of application of Sevoflurane anesthesia induction in anesthesia management of foreign matter removal from trachea in children.Methods Sixty five cases of children with tracheal foreign matter related in our hospital from January 2015 to December 2016 were selected as the study objects,and were divided into two groups according to random number table method.The control group of 32 cases was given 2.5 mg/kg propofol to induce anaesthesia,and the observation group of 33 cases was given 8％ Sevoflurane inhalation to induce ancsthesia.One shot success rate,deoxygenation time,operation time,recovery time and the relative parameters (systolic pressure,diastolic pressure,respiratory rate and pulse oxygen saturation) at entrance time,before and after setting the mirror were contrasted and analyzed,and the intraoperative and postoperative adverse reactions were recorded in the two groups.Results There were no significant differences in respiratory rate,blood oxygen saturation,systolic blood pressure and diastolic blood pressure between two groups at entrance time and before setting the mirror (P ＞ 0.05).The respiratory rate and blood oxygen saturation of the observation group were higher than those of control group after setting the mirror and at withdrawing mirror time,with statistically significant differences (P ＜ 0.05).No statistically significant differences in other indexes (P ＞ 0.05).Deoxygenation time,operation time and recovery time of the observation group were significantly lower than those in the control group (P ＜ 0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusions Sevoflurane anesthesia induction can obviously shorten operation time and recovery time in foreign matter removal from trachea in children,and reduce the incidence of intraoperative and postoperative adverse reactions.It has good clinical effect.

requirement of medical materials for hemolysis experiment (<5%) .MTT assay showed that , after 4 days of culture , the optical densi-ties were 0.498 ±0.218 and 0.566 ±0.266 in the 120℃12 h and 24 h groups and 0.668 ±0.268 and 0.769 ±0.213 in the 150℃12 h and 24 h groups, while after 8 days, the optical densities were 0.767 ±0.267 and 0.836 ±0.236 in the 120℃12 h and 24 h groups and 0.765 ±0.265 and 0.903 ±0.303 in the 150℃12 h and 24 h groups, all significantly higher than in the non-CaTiO3 group at 4 (0.341 ±0.143) and 8 days (0.731 ±0.121) (P<0.05). Conclusion The CaTiO3 coating on titanium is neither mutagenic nor hemolytic and has no toxicity on osteoblasts .Instead, it can promote the proliferation of osteoblasts , and therefore is a valuable coating material for implants .

Objective To understand the prevalence and risk factors of Enterobius vermicularis among preschool children in kindergartens in Luohu District Shenzhen City. Methods A total of 489 children in 6 kindergartens were selected by the stratified sampling method and investigated for E. vermicularis infection by the cellophane anal swab technique. The information of sanitary condition of the kindergartens personal hygiene and family hygiene were investigated by questionnaire. Results The infection rate of E. vermicularis was 10.2% 50/489 . The single factor analysis indicated that the following factors might re?lated to the infection the different classes of kindergartens grades ground of bed room private toilet types of taps and beds bed management education levels of parents frequency of shower and washing anus and washing hands before meal and after WC. The multivariate Logistic analysis indicated that the bed management education level of mothers frequency of washing anus and private toilet were independent risk factors for E. vermicularis infection. Conclusion To control the infection of E. vermicularis the circumstance and management of kindergartens parents knowledge of E. vermicularis infection and chil?dren s healthy habit need improve.

It has long been one significant focus in the field of surgery to reduce postoperative incisional complications.Recently,incisional negative pressure wound therapy (iNPWT),which was designed to reduce the incidence of incisional complications,has gradually been applied for primary incision closure.This article reviews the relevant basic and clinical studies to elucidate the mechanism of iNPWT and its clinical safety and efficacy,and answers some fundamental questions regarding clinical application of iNPWT.