BACKGROUND: Continuous passive motion assisted with diathermia will promote the restoration of joint movement of the extremities.OBJECTIVE: To improve joint movement with continuous motion assisted with diathermia after surgical treatment on simple fracture of upper or lower extremity.DESIGN: A randomized controlled trial.SETTING: Huaxi Hospital of Sichuan University.PARTICIPANTS: Eighty-four cases of simple extremity fracture treated in the Orthopedic Department of Huaxi Hospital of Sichuan University from October 2000 to July 2002 were included in this trial. Of them, 16 cases were elbow movement disorder and 68 were knee movement disorder. They were randomly assigned into two groups with 42 cases each.METHODS: The 42 cases in the treatment group were preheated before continuous passive motion while those in the control group just received continuous passive motion. The improvement of joint movement between thetwo groups were assessed and compared according to the joint movement scale.MAIN OUTCOME MEASURES: The joint movement before and after treatment and the indices of joint movement scale in the two groups.RESULTS: All of the eighty-four cases entered the analysis. The joint movement in the treatment group was better than that in the control group [ (101.40 ± 25.76)° vs (86.14 ± 27.66)°, t = 5.25, P ＜ 0.01 ]. The index of joint movement scale in the treatment group was also higher than that of the control group[ (84.32 ± 16.54) vs(64. 89 ± 13.76) ] ( t = 4.24, P ＜ 0.01 ) ].CONCLUSION: Continuous passive motion assisted with diathermia is better than simple continuous passive motion in improving the joint movement and function of elbow and knee.

Objective To explore the contents and modes of community nursing training and improve community care quality.Methods The training course and assessment standard were worked out according to practical work in community health service centers,including basic nursing skills,community first aid skills,hospital infection control skills,preventive health care skills and community document management skills.Toally 58 nurses from 11 community health service centers were trained for 36 hours from January to June,2016 and tested before and after training to assess the effect of training.Result After training,the scores on all skills were significantly higher than those before training (all P＜0.01).Conclusion Regular and practical training and management are the guarantee for the improvement of the community care quality.

Objective Effects of hepatocellular carcinoma of antisense insulin like growth factor Ⅱ (antisense IGF Ⅱ) combined with muramyl dipeptide (MDP) was studied. Methods A cDNA fragment of human IGF Ⅱ was synthesized and inserted into a eukaryotic expression vector of pcDNA 3 (antisense IGF Ⅱ ). Antisense IGF Ⅱ and MDP encapsulated with liposomes were introduced into HepG 2 human hepatocellular carcinoma cells and were injected into subcutaneous tumors generated in nude mice. The growth of HepG 2 cells transfected with antisense IGF Ⅱ and MDP, and the subcutaneous tumors injected with antisense IGF Ⅱ and MDP were observed. Results The growth of HepG 2 cells was blocked completely, and the subcutaneous tumors disappeared in two of five nude mice. Conclusions The combination therapy of antisense IGF Ⅱ and MDP is effective in the treatment of hepatocellular carcinoma.

Objective To construct the expression vector of siRNA targeting the human protection of telomeres (hPOT1) gene for the observation of the inhibitory effect of the vector on hPOT1 gene expression in gastric cancer cell line SGC-7901, and to offer a ground work for further study on the roles of hPOT1 in growth and proliferation of gastric cancer cells. Methods 64 base-pair oligonucleotide for small interfering RNA expression targeting hPOT1 gene was designed and chemically synthesized. After annealing, double oligonucleotides were inserted into the downstream of H1 RNA promoter of pSUPER to recombine psiRNA-hPOT1 plasmids, and transiently transfected into gastric cancer cell line SGC-7901 with liposome-mediated transfection after restriction enzyme and sequencing analysis. Semi-quantitative RT-PCR was used to detect the expression levels of hPOT1 gene. Result Recombinant psiRNA-hPOT1 vector was confirmed by sequencing analysis. The results demonstrated that 64nt had been inserted into the expected site. Furthermore, the inserted sequence was exactly correct. The recombinant psiRNA-hPOT1 vector could significantly suppress the hPOT1 expression in gastric cancer cell line SGC-7901. Conclusion The constructed siRNA expression vector of hPOT1 gene psiRNA-hPOT1 recombinant plasmid can block the expression of hPOT1 gene in gastric cancer cell line SGC-7901.

Objective To compare the propagation speed and physical parameters between underwater blast wave and air blast wave. Methods The physical parameters of blast wave were measured by PCB pressure transducers (USA) during underwater and air explosions of 200g, 500g and 1000g TNT respectively. Consequently, the propagation speed, peak overpressure value, positive duration and impulse of blast wave were analyzed. Results Underwater blast wave was characterized by high propagation speed, high peak overpressure value, great impulse, however, short duration. Compared with air blast wave, the propagation speed of underwater blast wave was 3.70-4.30 times higher than that of air blast wave, the peak overpressure value was 227.15-247.86 times higher, and the impulse was 8.48-11.80 times greater than that of air blast wave. Conclusion Underwater blast wave propagates faster than that air blast wave. Meanwhile, it also peoduces higher peak overpressure value and impulse. This result is helpful for the evaluation of injury severity and treatment of underwater blast injury.

Objective To investigate the effect of vacuum sealing drainage (VSD) technology on prevention and treatment of infection wound and to repair the infectious fracture wound in earthquake. Methods Twenty-two patients with limb fractures and open infection wound received VSD from May 12, 2008 to June 19, 2008 in West China Hospital of Sichuan University. Before the VSD, we debrided all wounds and gave effective systemic antibiotics. A -18 ～ - 14 kPa pressure was exerted to the wound, and the VSD was used for 8 ～ 10 days. We took a germiculture regularly. The capacity, color, and nature of negative pressure drainage, the regression of limb swelling, and systemic inflammatory responses were observed. Results There was no active bleeding wound or transparent film off in all patients. Three patients had drainage clogging, and were kept flowing freely using the sterile saline pipe to remove the blockage of necrotic tissues. During the VSD, granulation tissues grew well in the 13 patients with bone exposure of the wounded. Two patients whose symptom of inflammatory was not obviousy eased had another debridement to completely remove the necrosis, and the symptom was relieved. After 3-5 days of VSD, swelling and fever in the other 20 patients significantly subsided. Conclusion VSD can alleviate the wound inflammation, facilitate the growth of the fresh granulation tissue from the surrounding to the center, and reduce the flap transfer area for the Stage Ⅱ coverage of the exposed bone.

Objective To discuss the diagnostic value of 3D-ultrasound for cord entanglement in monoam-niotic twins. Methods From November 2013 to March 2016,a total of 65 monoamniotic twinsunderwent routine obstetric ultrasonography to screen fetal abnormalities in our hospital. The cord was meticulously observedusing a systematic continuous sequence approach. Fetuses who showed cord entanglement by 2-D ultrasound or 3-D flow Doppler were all recruited. The gestational weeks,fetal malformation,ultrasonic image feature of cord entangle-ment,and clinicaloutcome were recorded and analyzed retrospectively. Results 4 monoamniotic twins showed cord entanglement. Three-dimensional color Doppler clearly delineated thefeatures of entanglement. At following-up of 8 fetuses,3 fetuses were found intrauterine fetal death and 3 fetuses with structural abnormalities except for 2 well infants.Conclusion Cord entanglement may threaten the safety of fetusesin monoamniotic pregnancies.In aid of 2-D ultrasound or 3-D flow Doppler in monoamniotic twins can help to find it in time ,monitor it carefully and provide evidence for obstetric treatment .

Objective To evaluate the significance of homocysteine(HCY)and color Doppler flow imaging(CDFI)in the diagnosis and treatment of the renal damage in hypertension.Methods Seventy-two patients were divided into 3 groups according to the indicators of renal damage of hypertension.HCY in blood and the parameters of three grades renal artery with CDFI were measured and compared with 20 controls.Besides these，the relationship between HCY and resistant index(RI)of interlobar renal artery (IRA)was also analysed.Results①The level of HCY in hypertension was much more higher than the level in controls.HCY increased with the damage of renal function，and there were significant differences between different groups(P＜0.05).②The Vmax and Vmin were slower gradually，but PI and RI were higher with the severity of the renal damage(P＜0.01).③HCY were positive correlation with IRNs RI(r=0，35，P＜0.0 1).Conclusions The changes of CDFI can reflect the conditions of renal blood flow，it is possible to know renal blood flow by measuring RI of IRA.The level of HCY will increase gradually with the degression of renal function，it iS useful to evaluate the renal damage.The measurement of CDFI for hypertensive patients is valuable not only for the evaluations of their renal function but also for the severity of hyperhomocysteinemal and their therapy condition.

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Guardian for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients of both sexes,aged 26-64 yr,weighing 48-95 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,with Mallampati grade Ⅰ-Ⅲ,scheduled for elective laparoscopic cholecystectomy under general anesthesia,were divided into group Ⅰ and group Ⅱ (n =30 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA Guardian.In group],the nasogastric tube was inserted through the nostril before operation,and after successful LMA Guardian placement,another nasogastric tube was inserted through the drain tube of LMA Guardian.The hemodynamic parameters,SpO2,end-tidal pressure of carbon dioxide and peak airway pressure (Ppeak) were monitored during operation.The fiberoptic laryngoscopy scores were assessed after successful LMA placement,and the nasogastric tube displacement was recorded.The LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,occurrence of air leakage of LMA and nasogastric tube drainage were recorded.The bloodstains and gastroesophageal reflux were observed after removal of the LMA.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after operation.Results The hemodynamics was stable,the SpO2 and Ppeak were within the normal range during operation,and Ppeak was lower than airway sealing pressure in the two groups (P＞0.05),and there was no significant difference between the two groups.There was no significant difference between the two groups in the LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,score for exposure of oropharynx,development of adverse reactions in the oropharynx,consumption of anesthetics,development of bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA (P＞0.05).Nasogastric tube drainage:the rate of nasogastric tube drainage through the LMA Guardian was 67％ in group Ⅰ;the rate of nasogastric tube drainage through the nostril was 40％,and the rate of nasogastric tube drainage though the LMA Guardian was 50％ in group Ⅱ.No nasogastric tube displacement was found after operation in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA Guardian is easy,and LMA Guardian can assure good airway sealing and adequate ventilation and can be safely and effectively used for airway management in this type of patients.

AIM:To investigate the mechanism of apoptosis during the process of adult rat mesenchymal stem cells(MSCs)differentiating into neuron-like cells in vitro.METHODS:The MSCs were isolated primarily from adult rats bone marrow by density gradient and then expanded in medium as undifferentiated cells for 3-5 generations.The MSCs were divided into three groups at random.The control group was induced with ?-mercaptoethanol(?-ME).Meanwhile,the U0126 group was given ?-ME and U0126(10 ?mol/L)added at the beginning of induction.The PMA groups were treated with ?-ME and different concentrations of PMA since pre-induction.The effects of U0126 and PMA on the activity of neuron-like cells were observed by MTT.The effects of U0126 and PMA on the expression of neuron specific marker nestin and expression of apoptosis-related protein caspase,Bcl-2,Bax in neuron-like cells were detected by using immunocytochemistry method.TUNEL technique was used to detect apoptosis index.RESULTS:Compared to control group,neuron viability,nestin and Bcl-2 increased and neuron apoptosis decreased in U0126 group(P