Objective To discuss clinical results of the treatment of op en tibio-fibula fractures with the intramedullary interlocking nails. Methods A group of 46 cases of open tibio-fibula fractures was collected and classified according to Gustilo classification. There were 12 cases of type Ⅰ, 9 cases of type Ⅱ, 16 cases of typeⅢA, 7 cases of type ⅢB, and 2 case of type ⅢC. All o perations were performed in the emergency operation room and all patients were f ixed with intramedullary interlocking nails. Results The follow-up of 8 months to 3 years (with an average of 20 months) showed satisfactory results, though th e local wounds needed skin flap transplantation in 6 cases and muscle flap trans plantation was performed in 1 case. Conclusion Open tibio-fibula fractures of t ype Ⅰ, type Ⅱ and type ⅢA can be treated with emergency debridement and the intramedullary interlocking nails, if the injury duration is short and the vital signs of the patients are stable.

Objective In order to understand the mechanisms beyond lipid regulation of 3 hydroxy 3 methyl glutaryl coenzyme A(HMG CoA) reductase inhibitors in anti atherosclerosis, we observed the influence of pravastatin on the pathogenesis of atherosclerotic lesions and the expression of intercellular adhesion molecule (ICAM) 1 in aortic wall of the apoE deficient mice. Methods Pravastatin(10 mg?kg?d -1 ) was fed to 10 , 20 , and 30 week old male apoE deficient mice respectively for 4 weeks. The atherosclerotic plaque size and the ratio of plaque area to aortic luminal area (PA/LA) were determined by histochemical staining and analyzed quantitatively. The expression of ICAM 1 in aortic wall of apoE deficient mice was detected by immunohistochemistry and Western blotting. Results Compared with controls, pravastatin delayed the plaque formation in apoE deficient mice 〔(161 786 1?38 041 2) ?m 2 vs (99 127 9?13 600 3) ?m 2, P

AIM: To investigate the hypothesis that low-molecular weight heparin (LMWH) regulates in vitro cytotrophoblast invasiveness and production of metalloproteinases-2 (MMP-2), tissue inhibitor of metalloproteinas-2 (TIMP-2). METHODS: Chorionic villi tissue of normal 6-8 weeks pregnancy was obtained. Trophoblastic cells were collected by trypsin-collagenase digestion and Percoll gradient centrifugation. The cytotrophoblastic cells were cultured for 24 h and divided into 4 groups according to the concentrations (1.0×10~2 IU/L, 1.0×10~3 IU/L or 1.0×10~4 IU/L) of LMWH adding into the medium. The contents of MMP-2 and TIMP-2 in cell culture supernatants were measured by the method of ELISA. Cytotrophoblast invasiveness was determined by Transwell chamber assay. RESULTS: With the increasing concentrations of LMWH, the invasion activity of cytotrophoblastic cells and MMP-2 secretion were increased. At concentration of 1.0×10~3IU/L, LMWH greatly enhanced cytotrophoblast invasiveness and the expression of MMP-2 (P<0.05). The levels of TIMP-2 were decreased after intervention with LMWH. At concentration of 1.0×10~3IU/L or 1.0×10~4 IU/L, LMWH induced a significant decrease in TIMP-2 expression. No significant difference between group 1×10~3IU/L and group 1.0×10~4 IU/L was observed (P>0.05). CONCLUSION: LMWH might regulate cytotrophoblast invasiveness in vitro by influencing the expression of MMP-2 and TIMP-2 in cytotrophoblastic cells.

We evaluated clinical application effect of gene chip for detection of rifampin (RFP) and isoniazid (INH) resistance in Mycobacterium tuberculosis (MTB).Rifampin and isoniazid drug-resistance gene loci were detected by gene chip with sputum specimens from smear-positive tuberculosis patients and clinical strains,comparing the results of detection.BACTEC MGIT 960 drug susceptibility test results were used as control to evaluate the detection performance of gene chip.The sequences of the polymerase chain reaction products of the rpoB,katG and inhA genes from 999 strains identified as Mycobacterium tuberculosis were determined to confirm the mutations by DNA sequencing.Results showed that 100 cases were identified as nontuberculous mycobacteria by gene chip in the 1 108 cases of smear-positive samples.Among the rest 1 008 samples,there were only 9 cases of microarray results different from BACTEC MGIT960 culture-positive strains,achieving the coincidences of 99.1％.Compared with BACTEC MGIT 960 drug susceptibility test results,the gene chip method displayed a concordance of 98.1 ％ and 94.5 ％ for RFP and INH respectively in the 999 strains.Compared with the DNA sequencing method,the accuracy of gene chip method was 99.6％ for rifampin resistance and 99.8％ for isoniazid resistance.It's concluded that the gene chip technology can quickly and accurately detect rifampin and isoniazid resistance in MTB and can be used directly for the detection of sputum samples.

Objective To measure the value of orthopedic physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth modified POSSUM (P-POSSUM) scoring systems in predicting operative risks in aged hip fracture patients.Methods Orthopedic POSSUM and P-POSSUM were performed to predict complication incidence and mortality for 164 aged patients operated for hip fracture.Validation of the scoring systems was tested by assessing observed to expected ratio,discrimination,and calibration.Discriminative ability and calibration of both scores were estimated using receiver operation characteristic curve (ROC) and Hosmer-Lemeshow test respectively.Results Orthopedic POSSUM score performed in predicting incidence of postoperative complications showed overall observed to expected ratio of 0.86,area under the curve of 0.82,and good calibration (H2 =3.66,df=8,P ＞ 0.05).P-POSSUM performed in predicting mortality showed overall observed to expected ratio of 0.80,area under the curve of 0.93 and good calibration (H2 =3.21,df =4,P ＞ 0.05).While orthopedic POSSUM overestimated postoperative mortality (overall observed to expected ratio =0.27).Conclusion Orthopedic POSSUM and P-POSSUM scores are respectively accurate in predicting postoperative complication incidence and mortality in aged hip fracture patients,but orthopedic POSSUM score overestimates the mortality.

Objective To investigate the value of MSCTA in diagnosing the origin of abdominal ectopic ovarian tumor. Methods Twenty-eight patients with 30 ectopic ovarian tumors that mainly manifested as abdominal lumps were evaluated with MSCTA retrospectively. Vascular three-dimensional reconstruction by VR based on add vessel (AV) and MIP was performed for all these patients after MSCT scanning.The origin of these tumors was judged by the feeding artery and ovarian vascular pedicle (OVP) sign.The result was compared with surgical findings.Results The maximum diameter of the 30 ectopic ovarian tumors ranged from 5.2 to 19.5 cm with an average of 9.3 cm.Of the 30 ectopic ovarian tumors, the ramus ovaricus arteriae uterinae (ROAU) and ovarian artery (OA) were demonstrated in 96.7% (29/30) and 56.7% (17/30) respectively.The feeding artery of the tumor was ROAU (29 cases) or OA (1 case), and OA participated in feeding the tumor in 16 cases.The accuracy rate of diagnosis of ectopic ovarian tumors according to the feeding artery was 100% (30/30).According to OVP the accuracy rate was 85.2% (23/27) with an incidence of 76.7% (23/30).Conclusion By showing ROAU and OA as the feeding artery and ovarian vein (OV) as the draining vein, MSCTA can accurately diagnose ectopic ovary tumors in the abdomen.

Objective To demonstrate the imaging characteristics of pancreatic neuroendocrine neoplasm (P-NEN).Methods The CT and MRI findings of 43 cases of P-NEN confirmed by pathology were analyzed,and compared with pathological results.Results Mean size of 43 lesions in 43 P-NEN patients were (25.00± 1.82)mm.Necrosis cystic degeneration were found in 26 lesions.In CT plain scan,15 lesions were isodense,28 lesions were hypodense.All of 43 lesions were hypointensity signal on T1WI;27 lesions were hypointensity signal,16 cases were isointensity signal on T2WI.Twenty-seven lesions showed envelope;30 lesions showed clear outline.In enhancement images,24 lesions were marked enhancement since arterial phase;8 lesions showed delayed enhancement;5 lesions showed centrality enhancement;6 lesions showed wild enhancement.Conclusion P-NEN has some characteristics on CT and MRI scanning,imaging can play an important role in diagnosis for P-NEN.

Specific to the existing problems of uneven distribution of resources in the medical industry,especially the shortage of grass-root high-quality medical resources,the paper introduces the construction objective,overall architecture and construction contents of regional medical collaboration,and normalizes the medical service process through informationalized technological means,in order to promote standardized construction of the regional medical information system and information interconnection and intercommunication.

OBJECTIVETo establish the characteristic fingerprint of Zanthoxylum nitidum by HPLC, and to provide a reference for the quality control of Z. nitidum in the market.

METHODThe established HPLC characteristic fingerprint of Z. nitidum, combined with similarity evaluation and system clustering analysis method, were applied to distinguish 25 batches of samples purchased from market preliminarily, to identify the authenticity and quality of Z. nitidum ingredients.

RESULTIn the 25 batches of samples purchased from market, only 8 batches were identified as genuine with good quality, 7 batches were identified as defective, 7 batches were identified as common counterfeit Toddalia asiatica, and 3 batches were identified as counterfeit.

CONCLUSIONThis method is accurate, convenient and reliable. It can be used for identification and quality control of Z. nitidum ingredients.

Objective To evaluate the influence of SOCS3 conditional ablation in macrophage polarization and functional recovery after spinal cord injury in mice.Methods The Socs3fVfl Nes cre mice were used to obtain nervous-system-restricted SOCS3 deletion models as experimental group (n=40),and littermate Socs3fl as control group (n=40).Mice (n=35) in each group were underwent T10 spinal cord compressing injury (the left 5 were as sham-operated controls);on the third,7th and 14th d of injury,injured tissues from 15 mice of each group were harvested;immunofluorescence was performed to detect the changes of M2a and M2c phenotypic marker Arginase1 and M1 and M2b phenotypic marker CD86;on the first,third,7th and 14th d of injury,injured tissues from the left 20 mice from each group were harvested;fluorescent quantitative real time-PCR was used to detect the macrophage phenotypic markers (Arginasel,CD206,iNOS and CD32),SOCS3 and STAT3 gene expressions;the above data from the sham-operated controls were used as base data.BMS scale was used to evaluate the motor functions of posterior limbs and bodies on the first,third,7th and 14th d of injury.Results The behavioral assessments of the experimental group were superior on the third,7th and 14th d of injury as compared with those of control group (P＜0.05).Immunofluorescence showed that as compared with the controls,the Socs3fVfl Nes cre mice had a predominance in distribution and population of Arginasel-positive macrophages in spinal cords on the third,7th and 14th d of injury;in contrast,the control group showed superiority of CD86 expression on the 7th and 14th d,with significant differences (P＜0.05).Similarly,fluorescent quantitative real time-PCR analysis demonstrated that gene expression of A rginase I on the 7th d of injury,that of CD206 on the 7th and 14th d of injury,and that of STAT3 on the third,7th,and 14th d of injury were significantly increased,whereas that of CD32 on the 14th d of injury and SOCS3 on the first and third d of injury were significantly reduced in the experimental group,as compared with those in the control group (P＜0.05).Conclusion SOCS3 conditional knockout can promote the formation of M2 macrophage,as well as good functional recovery after spinal cord injury in mice.