Protein kinase B (Akt) is a Ser/Thr kinase,which in mammals comprise three highly homologous members known as PKB?/Akt1,PKB?/Akt2 and PKB?/Akt3. PKB is activated by hormones?growth factor and extra cellular matrix. The activation occurs downstream of PI3K. PKB phosphorylates and regulates the function of many cellular protein involved in processes that include survival,apoptosis, proliferation,glycogen metabolism and cancer progression. Although many mechanisms remains to be fully characterized,the research of PKB is thought to have a useful profect.

[Objective]To study the techqiue and method of using in-situ replantation of dead bone to treat infected nonunion of femur. [Method] Debridement and removal of dead bone were carried out in 2 patients who had a chunk of dead bone and multiple sinus without involucrum formation.Sterilized sequester was replanted in-situ,tibia traction was performed and continual Kawashima's irrigation was applied with sensitive antibiotic after surgery.[Result]The time of bone healing in 1 case was ten months.The patient was followed up for 42 months,there was no recurrence of osteomyelitis.The time of bone healing in another case was about 12 months,he was followed up for 30 months,there was also no recurrence in this patient.[Conclusion]Traumatic osteomyelitis complicated with a massive sequester and nonunion could be cured by process which included debridement,in-situ replantation of sterilized death bone,continual washing as well as comprehesive treatment.It could achive the two primary purposes,inflammation cure and bone healing.Among these methods,improved Kawashima's irrigation is the most important method for inflammation cure and bone union.

BACKGROUND:Traditional distal femoral fixation plate screw breakage is relatively common. Designing good anatomical and attached fixation system is the key for clinical application.
OBJECTIVE:To perform finite element analysis in two states of motion of the minimal y invasive distal femoral fixation system, compare stress distribution of different parts in the same fixed way, different fixed methods and the same fixed parts of different motion states.
METHODS:Imaging data of a 34-year-old male patient weighing 68 kg with 33-C1 type fracture of distal femur were selected. CT data were input into Mimics 16.0 for reconstruction. PRO-E software was used to establish minimal y invasive internal fixation system with distal femoral locking plate. Data were introduced into reconstructed models of distal femur fracture in Mimics for grid division. Data were introduced into Ansys products 11.0 to construct finite element model, fix the surface of distal femur, and loaded 340 N on greater trochanter of femur. Stress distribution of each plate, screw hole and screw tail was analyzed in each group. Stress at the same region was compared in flexion and extension movement states.
RESULTS AND CONCLUSION:(1) Finite element models of anatomic locking plate for distal femur fracture fixation were successful y established, total y 43 536 units, 41 256 nodes. (2) With the steel segment gradual y down (S1-S5), the stress gradual y increased. A1-A5 with the increase in the number of screws, the stress gradual y increased, but A6 suddenly decreased. (3) According to the cloud atlas of stress, these were wel distributed except A1. From distal end to extremity of screw, the stress of screws increased. Among corresponding segments, significant differences in stress around the nail holes and steel segment stress were detected. Moreover, the steel stress was greater than the stress of corresponding segment of screw hole. (4) Results suggest that using anatomical locking plate and minimal y invasive internal fixation system for distal femur fracture in a variety of fixed modes and moving conditions, the stress of each part is less than the yield strength of the titanium al oy screw, so the fixed system wil not produce instantaneous deformation or fracture.

OBJECTIVE: To evaluate the use and tendency of anti-rejection drugs in six cities in the Yangtze valley.METHODS: The consumption data for anti-rejection drugs in the Yangtze areas during the period 2004～2006 were analyzed statistically by the method of order of consumption sum.RESULTS: The anti-rejection drugs used in the Yangtze valley increased year by year,up 28.4% in 2005 and 23.9% in 2006 over the previous year.On the list of consumption sum for the six cities in Yangtze valley,the proportions for Shanghai over the 3 years were 67.1%,62.5% and 65.4%;those for Hangzhou were 12.6%,16.7% and 14.7%;5.3%,4.6%,4.6% for Nanjing;7.6%,9.0% and 7.4% for Wuhan;4.9%,4.5%,5.0%for Chendu,and 2.5%,2.7% and 2.9% for Chongqing.CONCLUSION: The consumption of anti-rejection drugs was unbalanced among the 6 cities in the Yangtze areas,but its clinical application was basically in line with the marketing of new drug both at home and abroad.The import drugs occupied the biggest market share,while the market share of the domestic drugs increased slowly but steadily.The prices for anti-rejection drugs were still very high,which should be lowered to reduce patients' economic burden.

To investigate the effects of ketamine on nitric oxide synathase(NOS)activity, nitrc oxide (NO) output and cyclic guanosine 3', 5'-monophosphate(cGMP)content in the rat brain. Method: Thirty two SD rats were divided randomly into control group and ketamine group. The aminals were administred intraperitoneally(ip)normal saline 10mg?kg~(-1) or ketamine 100mg?kg~(-1), respectively. NOS activity and NO output were assassed with spectrophotometric analysis, cGMP content was measured with radioimmunoassay, Result: Ketamine 100mg?kg~(-1) ip significantly inhibited NOS activity(P

Tn investigate the effects of propofol on Ca~(2+) ATPase activity in rat cerebral synaptic membrane. Method: Thirty SD rats were divided randomly into three groups. The aminals were administtered introperi toneally(ip) propofol 50mg?kg~(-1), 100mg?kg~(-1) or normal saline 10mg?kg~(-1)(control group), respectively. These rats were immediately decapitated after having disappeared righting reflex. In oredr to prepare synaptosomes, brain tissues were dissected on ice, then homogenized and centrifuged. Ca~(2+)-ATPase activity was assaed with spcetrophotometric analysis. Result: Propofol 100mg?kg~(-1) ip significantly inhibited Ca~(2+)-ATPase activity of cerebrocortical, brain stems and hippocampal synaptic membrane as compared with that of normal saline group(P

Objective:To investigate effects of propofol on nitric oxide synthase (NOS) activity and nitric oxide (NO)output of rat brain. Method: Sixteen SD rats were divided randomly into two groups. The animals were administered introperitoneally(ip) normal saline 10 ml?kg~(-1)(control group)or propofol 100mg?kg~(-1)(propofolgroup),respectively. These rats were decapitated immediately after having disappeared righting reflex. After rapid removal of cerebellum, brain stem,hippocampus and cerebral cortex,tissues were homogenized and centrifuged. NOS activity and NO output were assayed with spectrophotometric analysis. Result: In propofol group,NOS activity was significantly inhibited, NO outpul was significantly reduced in cerebellum, brain stem,hippoeampus and cerebral cortex as compared with those of control group(P

Objective To observe the liver function changes in patients after enteral nutrition through nasal jejunal tube.Methods Altogether 74 inpatients requiring enteral nutrition were collected for this study from September 2011 to August 2014 in the Intensive Care Unit of Zhengzhou People's Hospital and divided into 2 groups with random number table:the nasal jejunal tube group (n =36) and the nasogastric tube group (n ＝38),with nasal jejunal tube and nasogastric tube inserted,respectively,for early enteral nutrition.We observed the two groups of patients in terms of liver function indexes on day 7 and day 14 after starting enteral nutrition.Results In the nasal jejunal tube group,31 patients (86.11％) showed abnormality in at least 1 liver function index,while that number was 23 in the nasogastric tube group (60.53％),with significant inter-group difference (x2 =6.136,P =0.013).On day 7 after enteral nutrition,there were no significant differences in alanine transaminase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptidase (γ-GGT) and albumin (ALB) between the two groups [(39.1 ± 8.6) U/L vs.(42.3 ±8.9) U/L,t=-1.475,P=0.145;(36.2±6.8) U/Lvs.(38.0±7.1) U/L,t=-1.237,P=0.220;(61.8±11.5) U/Lvs.(63.1 ±13.2) U/L,t=-0.696,P=0.489;(47.3±8.2) U/Lvs.(50.5±7.5) U/L,t=-1.640,P=0.106;(35.2±6.7) g/Lvs.(36.2±7.4) g/L,t=-0.610,P=0.543];but on day 14,the nasal jejunal tube group had significantly higher levels of ALP,γ-GGT,and ALB compared with the nasogastric tube group [(201.2 ± 15.2) U/L vs.(116.5 ± 13.6) U/L,t =-25.380,P =0.000;(109.4±7.2) U/Lvs.(49.2±6.5) U/L,t=-37.665,P=0.000;(37.2±7.1) g/Lvs.(30.1±6.5) g/L,t =-4.490,P =0.000].On day 7 and day 14,there were no statistically significant differences in totalbilirubin [(4.6±0.9) μmol/L vs.(4.8 ± 1.0) μmol/L,t =-0.905,P=0.368;(4.8±12) μmol/Lvs.(5.2±1.1) μmol/L,t=-1.492,P=0.140],indirect bilirubin [(6.1 ±0.8) μmol/Lvs.(6.3±0.9) μmol/L,t=-1.012,P=0.315;(6.9±0.9) μmol/L vs.(7.3±1.0) μmol/L,t=-1.811,P =0.074],and direct bilirubin [(4.0 ± 0.6) μmol/L vs.(3.9 ± 0.5) μmol/L,t =0.777,P =0.440;(5.1 ±0.8) μmol/L vs.(5.4±0.9) μmol/L,t=-1.517,P=0.134] between the nasogastric tube and the nasal jejunal tube groups.The incidence of pulmonary infection in the nasal jejunal tube group was significantly lower than that in the nasogastric tube group (30.56％ vs.55.26％,x2 =4.598,P =0.032).Conclusion Compared with enteral nutrition through nasogastric tube,enteral nutrition through nasal jejunal tube may be more likely to lead to abnormal liver function.

Objective To verify the analytical performance of the portable Celercare M1 analyzer in the C-reactive protein(CRP) quantitative determination.Methods According to the standard program of the American Clinical and Laboratory Standards Insti-tute (CLSI),The portable Celercare M1 analyzer was performed the verification on the CRP detection in the aspects of the linearity range,precision,accuracy,interference test and method comparison.Results The CRP detection showed good linearity in the range of 0.5-200 mg/L and the regression equation was Y =0.979X +0.456.The within-run coefficients of variation(CV)of samples with low and high CRP levels were 5.9% and 2.0%,respectively.The between-day CV of samples with low and high CRP levels were 6.3% and 2.2%,respectively.The accuracy of the assay was admirable,and bias of CRP results at low and high levels were 2.3% and 0.7%,respectively.No significance interference was observed when serum bilirubin ≤340 μmol/L,triglyceride ≤10 mmol/L and hemoglobin ≤8 g/L in this method.The regression equation of Celercare M1 analyzer(Y )and the IMMAGE 800 (X) for detecting CRP was Y =0.944X +0.206,R 2 =0.996(P <0.05).The relative bias of CRP results in three medical decision levels (3,10,100 mg/L)was 1 .0%,4.0% and 5.0%,repectively,which was lower than 1/2 of total error allowance.Conclusion The linearity,precision,accuracy and interference of the Celercare M1 analyzer in CRP determination are admirable and can be accepted in clinical practice.

Objective To investigate the effects of intrathecal (IT) neostigmine on the excitatory amino-acid content in the L4-5 segment of spinal cord in a rat model of incisional pain. Methods Thirty-two male SD rats weighing 250-270 g were anesthetized with intraperitoneal pentobarbital 40 mg ? kg-1 . Intrathecal catheter was placed with the tip reaching the lumbar region according to the method of Yaksh. Five days later an 1 cm long incision was made in the plantar region of the right hind paw under isoflurane anesthesia according to the method of Brennan. Pain behavior was assessed at 1h after incision by cumulative pain score. The animals were randomly divided into four groups with 8 animals in each group: Ⅰsham operation group received IT artificial cerebro-spinal fluid (ACSF) 20 ?l but no incision was made in the hind paw; Ⅱ control group received ACSF 20 ?1 30 min before incision was made; Ⅲ postoperative neostigmine group received IT neostigmine 10 ?g 30 min after incision; Ⅳ preoperative neostigmine group received IT neostigmine 10 ?g before incision. 2h after incision the animals were decapitated and lumbar segment of spinal cord was removed for determination of aspartate and glutamate contents by high performance liquid chromatography (HPLC) with fluorescence detection. Results The cumulative pain scores in group Ⅱ were significantly higher than those in group Ⅰ (P 0.05) . Conclusion The decline in the increased excitatory amino-acid contents in spinal cord induced by incisional pain is involved in the mechanisms of analgesia provided by IT neostigmine.