BACKGROUND:The calcaneal fracture is the most common tarsal bone fracture. Approximately 75% calcaneal fractures presented as the displaced intraarticular fractures. How to treat intraarticular calcaneal fractures remains controversial. OBJECTIVE:To observe the anatomy and clinical effect of minimaly invasive percutaneous screw fixation in repair of Sander II calcaneal fractures under the arthroscope. METHODS:From May 2009 to May 2012, 61 patients (61 feet) with Sander II calcaneal fractures were repaired by minimaly invasive percutaneous screw fixation under the arthroscope. Al patients received clinical and imaging evaluation at 3, 6, 21 weeks, and 1 year after treatment. From then on, the evaluation was performed every year. American Orthopaedic Foot and Ankle Society ankle hindfoot score was used to assess ankle joint function. Simultaneously, complications such as skin necrosis and wound infection were recorded. Radiographic outcomes were assessed by Bohler angle, Gissane angle, calcaneal height and width. RESULTS AND CONCLUSION: A total of 61 patients were folowed up for 24 to 60 months. No complications were seen such as wound healing or deep infection. The time of hospitalization was 6-25 days, averagely (12.7±6.9) days. At the final folow-up, American Orthopaedic Foot and Ankle Society ankle hindfoot score was 88-100, averagely (93.6±3.1), with an excelent and good rate of 100%. The time of return to work after treatment was 8-14 weeks, averagely (10.7±2.9) weeks. Range of motion of ankle or subtalar joint of al patients was limited less than 10°. Immediate postoperative X-ray showed that anatomic reduction of the articular surface was detected in 56 patients (92%), and non-anatomic reduction was found in 5 patients (8%). At last folow-up, the mean Bohler angle was (28.4±4.9)° (range, 23°-30°); the mean Gissane angle was (119.9±7.8)° (range, 112°-124°); the mean calcaneal height was (43.4±4.2) mm (range, 39-45 mm); the mean calcaneal width was (30.4±2.5) mm (range, 27-32 mm); the average fracture healing time was (16.7±4.2) weeks (range, 12-20 weeks). Bohler angle, Gissane angle, calcaneal height, and calcaneal width at last folow-up were significantly improved compared with pretreatment (P < 0.05). These findings suggest that under the arthroscope, minimaly invasive percutaneous screw fixation for Sander II calcaneal fractures can restore calcaneal anatomy, achieve a satisfactory clinical function, without complications such as poor woundhealing or infection.

BACKGROUND:Unstable distal radius fracture is the most common fracture in the elderly patients, how to treat this kind of intra-articular distal radius fracture remains controversial. OBJECTIVE:To summarize the clinical, radiographic outcomes and complications of closed reduction and external fixation of the AO type C distal radial fracture. METHODS:From May 2009 to May 2012, we performed closed reduction and external fixation in 122 patients (122 wrists) with the AO type C distal radial fractures. According to AO fracture classification:C1 in 16 patients, C2 in 63 patients, and C3 in 43 patients. The study participants underwent clinical and radiographical evaluation at 3, 6, 12 weeks, and 1 year postoperatively and annual y thereafter. Wrist joint function of patients was anteroposterior and lateral X-ray films by palmar angulation, ulnar variance, radial height, and quality of articular reduction according to Knirck’s classification. RESULTS AND CONCLUSION:Al 122 patients were fol owed up for 13 to 28 months. The mean operative time was 19.1±11.2 minutes;the mean fluoroscopy time was 7.8±2.6 seconds;the mean bleeding loss was 45.7±14.8 mL;the mean length of hospital stay was 2.7±1.9 days;the mean union time was 3.1±0.7 months. At the final fol ow-up, the average modified McBride score was 6.7 points (range, 1 to 23 points), the rate of good to excel ent was 62%. The average palmar angulation was 11.7±2.6° (range, 10° to 15°). The average ulnar variance was 21.3±5.7° (range, 18° to 26°). The mean radial height was 12.9±2.8 mm (range, 10 to 16 mm). Quality of articular reduction based on Knirck and Jupiter’s classification shows Stage 1 in 108 patients and Stage 2 in 14 patients. Eight patients (6.6%) suffered from postoperative complications, including pin tract infection in six patients, sensory branch of the radial nerve neuritis in two patients. Results verified that closed reduction and external fixation of the AO type C distal radial fractures can achieve a satisfactory clinical function, has a less trauma, shorter hospital stay, lower rate of complications, faster fracture union, especial y is suitable for treatment of the AO type C distal radial fractures in the elderly.

BACKGROUND:Studies have suggested that high-viscosity bone cement can reduce bone cement leakage in the percutaneous vertebroplasty, but compared to the low-viscosity bone cement, there are stil some controversies on clinical advantages of high-viscosity bone cement. OBJECTIVE:To compare the bone cement leakage and clinical outcomes of high-viscosity and low-viscosity bone cement in percutaneous vertebroplasty for osteoporotic vertebral fractures. METHODS:Sixty patients with osteoporotic vertebral fractures were enroled in this study. Al patients were randomly divided into two groups: high-viscosity bone cement group and low-viscosity bone cement group. We compared the venous leakage rate, disc leak rate, visual analogue scale scores for low back pain, and Oswestry disability index between two groups. RESULTS AND CONCLUSION:Al patients were successfuly operated and low back pain and Oswestry disability index had significant improvement as compared with the preoperative status (P=0). By the final folow-up visit, there was no significant difference in disc leak rate, visual analogue scale scores, and Oswestry disability index between two groups. The venous leakage rate in the high-viscosity bone cement group was lower than that in the low-viscosity bone cement group (P=0). This study shows that high-viscosity bone cement can reduce bone cement leakage in the percutaneous vertebroplasty.

Objective To observe the influence of dexamethasone on M1 BMDM and alveolar macrophage differentiation in respiratory syncytial virus ( RSV) infected mice.Methods Culture M1 BMDM and identify its phenotype, observe the effect of DEX on its transcription factors and cytokines; In RSV infected mice, observe the influence of DEX on the transcription factors and cytokines of alveolar macrophage.Results DEX can inhibit IL-6, IL-12, iNOS and IRF5 expression, but promote IL-10, Arginase-1 and IRF4 expression in M1 BMDM and alveolar macrophages of RSV infected mice, made M1 macrophages transform to M2 macrophages.Conclusion DEX can transform M1 macrophages to M2 macrophages in vivo and in vitro, and inhibit inflammation, this may be one of the mechanism of DEX in the treatment of RSV infection.

Objective To investigate the expression of COX-2 in multiple myeloma(MM)and the relationship between myeloma cells proliferation and apoptosis.To provide a new prognosis factor and therapeutic target.Methods COX-2 from the 22 newly diagnosed MM,14 relapsed MM and PCNA,HSP70 of the newly diagnosed patients were detected by immunohistochemistry method.Results All the newly diagnosed MM exhibited positive COX-2 immunoreactivity.50% had strong COX-2 and 50% showed weak COX-2.Relapsed MM exhibited strong COX-2.COX-2 was related with serum β2 microglobulin,marrow plasma cells,hemoglobin,PCNA,HSP70(P=0.019,0.003,0.048,0.006,0.034).Conclusion COX-2 was overexpressed in MM.Prognosis of patients with strong COX-2 is poorer than those with weak COX-2.COX-2 may promote the proliferation and inhibit the apoptosis of myeloma cells.

Objective To investigate the change of plasma cholinesterases (CHEs) in the people with diabetes or fatty liver or overweight , and explore the role of CHE in these diseases .Methods The plasma CHEs in 2834 subjects were detected , and these subjects were divided into five groups , including diabetes , fatty liver , overweight , diabetes with fatty liver , and the normal groups . Results The plasma CHE activities in diabetes group , fatty liver group , overweight group , and diabetes with fatty liver group were all higher than the normal group [(8943 ±1896)U/L, (9716 ±1673)U/L, (8798 ±1710)U/L, (9385 ±1687)U/L vs (8028 ±1621) U/L], and the CHE level in the fatty liver group was highest among five groups .However, the CHE level in diabetes group or fatty liv-er group was not significantly different from that in the diabetes with fatty liver group .The CHE level of the people with components of metabolic syndrome (MS) was significantly higher than that without MS component [(8786 ±1514)U/L, (9141 ±1771)U/L, (9705 ±1628)U/L, (9138 ±1768)U/L, (9530 ±1607)U/L vs (7821 ±1324)U/L]),but the CHE level was not increased gradually with the increased MS component.The plasma CHE had a negative correlation with age ( P =0.00),but it had a positive correlation with triglyceride (TG), total cholesterol (TC), and body mass index (BMI)( P =0.00).Conclusions The plasma CHE activity was el-evated in diabetes group , fatty liver group , and overweight group , which might be a risk factor in these diseases .Controlling the plas-ma CHE might help to treat the metabolism diseases .

To promote clinical medical students' personal harmonious development,we have established the new problem-based teaching mode and reform the evaluation system in clinical teaching of obstetrics and gynecology and have obtained more satisfied teaching result.

AIM: To explore the mechanism of nicotine against the apoptosis induced by colchicines in rat cortical neurons.METHODS: Cortical neurons were cultured from newborn Sprague-Dawley(SD) rats(less than 12 h).The rate of apoptosis was measured by Hoechst33258 fluorescence staining in the neurons,and the activity of Akt473 was analyzed by assay kit Akt473.RESULTS: The apoptosis of cortical neurons can be induced by 0.1 ?mol/L colchicine.The phosphorlation of Akt 473 decreased significantly(1/3 times of the control group,P

Objective:To investigate the effect of licochalcone A on osteoarthritis in rats and its relationship with p38-MAPK inflammatory signaling pathway.Methods:A total of 160 male Wistar rats were randomly divided into blank non-intervention, blank intervention, arthritis non- intervention and arthritis intervention groups with 40 rats in each group. Rats in the arthritis groups were subjected to unilateral anterior cruciate ligament transection, while rats in the blank groups were only subjected to skin incision and suture. Rats in the intervention groups were treated by intra-articular injection of 1 mL 10 μmol/L licochalcone A for 8 successive weeks. Eight weeks later, the cartilage of rats in each group was stained with safranin, and osteoarthritis soft tissue was scored according to Osteoarthritis Research Society International guideline under the optical microscope. The cartilage was cultured in low glucose cell culture medium supplemented with 5% fetal bovine serum for 48 hours. The contents of nitric oxide, prostaglandin E 2, sulfated glycosaminoglycan and collagen II in the medium were determined by the chemiluminescence reaction method. The expression levels of p38, phosphorylated p38 (p-p38) and matrix metalloproteinase in cartilage tissue were detected by western blot assay. Results:The progress of osteoarthritis in rats treated with licochalcone A was slow. The Osteoarthritis Research Society International score in the arthritis intervention group was significantly lower than that in the arthritis non-intervention group [(3.8 ± 1.7) points vs. (9.7 ± 1.2) points, P = 0.0064]. The contents of nitric oxide, prostaglandin E 2, sulfated glycosaminoglycan, and collagen II in the arthritis intervention group were (77.84 ± 17.65) μmol/mg and (6.78 ± 1.76) ng/mg, (89.78 ± 9.76) μg/mg, and (1.78 ± 0.76) μg/mg, respectively, which were significantly lower than those in the arthritis non-intervention group [(107.56 ± 18.74) μmol/mg, (10.756 ± 1.87) ng/mg, (125.75 ± 8.87) μg/mg, (3.76 ± 0.88) μg/mg, (NO: P = 0.002; PGE 2: P < 0.001; sGAG: P < 0.001; Collagen II: P < 0.001). Western blot assay results revealed that the relative expression of p38, p-p38, p-p38 to total p38 ratio, matrix metalloproteinase in the arthritis intervention group were (3 454 ± 421), (2 072 ± 175), (0.65 ± 0.14 )and (1 776 ± 765), respectively, which were significantly lower than those in the arthritis non-intervention group (5 322 ± 323), (4 257 ± 184), (0.89 ± 0.11), (3 865 ± 874)( p38: P < 0.001; p-p38: P < 0.001; p-p38/p38: P = 0.002; MMP: P = 0.001). Conclusion:Licochalcone A can delay the progression of osteoarthritis in rats with osteoarthritis through inhibiting inflammatory reaction and cartilage matrix degradation, and p38-MAPK signaling pathway may be involved in the regulation process.

Objective To establish the norms of Self-rated Health Measurement Scale Version 1. 0 ( SRHMS V1.0) for urban residents in Guangdong. Methods We used regional stratified random sampling method to select 6000 urban residents of 5 cities in Guangdong ( including Guangzhou, Maoming, Shantou, Shaoguan and Shenzhen) for a questionnaire investigation with SRHMS V1. 0, and establish the norms of mean,percentile and threshold based on characteristics of SRHMS V1.0 scores. Results The residents can be divided into 8 groups on the basis of gender and cut-off point of age 40,50 and 60. The mean norms of SRHMS V1.0 total scores were:(78.57±10.10),(76.93±9.90),(75.33±10.66),(69.45±13.90)for males under age40,40-50,50-60 and above 60 respectively;(77.03±10.00),(74.55±10.27),(72.24±11.76), (66.48±14.37)for females under age40,40-50,50-60 and above 60 respectively. The percentile norms of SRHMS V1.0 from 5 percent to 95 percent were established with 5% as interval. The norms of cutting off scores were established as five states according to the scores of TS,namely severe poor health,poor health,gen-eral health,good health and fairly good health,with( x-s),( x-0.5s),( x+0.5s),( x+s) as cutting off scores. Conclusion The study established the SRHMS V1.0 norms for urban residents of Guangdong preliminarily,which provides reference for further research of the population''s health status and its impacting factors.