BACKGROUND:Numerous studies confirmed that compared with deltopectoral approach, deltoid-splitting approach for proximal humeral fractures has good therapeutic effects, but precise superiority remains poorly understood. OBJECTIVE:To compare the therapeutic effects of deltopectoral approach and smal incision deltoid-splitting approach in the repair of proximal humeral fractures using meta-analysis. METHODS:We retrieved MEDLINE, Embase, the Cochrane library, Wanfang Database and PubMed by computer for articles on control ed trials of deltopectoral approach and smal incision deltoid-splitting approach in the repair of proximal humeral fractures published from 2010 to 2014. Neer score, operation time, intraoperative blood loss, incision length, length of hospital stay, Visual Analogue Scale score, fracture healing time, and Constant score were used as evaluation indexes of Meta analysis. RevMan 5.2 software was used for analysis. RESULTS AND CONCLUSION:Eventual y nine articles were included, total y 721 patients, published from 2010 to 2014 years. There were eight in Chinese, and one in English. Meta-analysis results showed that compared with deltopectoral approach, deltoid-splitting approach in the treatment of proximal humeral fractures could shorten operation time, reduce intraoperative blood loss, shorten length of incision, elevate Neer score and Constant score (P<0.05). No significant difference in fracture healing time, hospitalization days, and Visual Analogue Scale score was detected between the two methods of surgical approach. These data indicated that compared with deltopectoral approach, deltoid-splitting approach in the repair of proximal humeral fracture has certain superiority. Deltoid-splitting approach can be firstly selected in the permit of hospital conditions.

BACKGROUND:Investigation regarding epidemiologic features of osteoporosis in many areas of China has been much reported. However, studies regarding large samples and multicenter in China have been rarely reported. It is said that published papers cannot give a good description about the epidemiologic features of osteoporosis at present.
OBJECTIVE:To understand the epidemiologic features of osteoporosis by evaluating the data on the epidemiology of osteoporosis in the middle-aged and elderly in China.
METHODS:Meta-analysis was used to evaluate the data extracted from 2000-2013 published papers on the epidemiology of prevalence rates of osteoporosis in the middle-aged and elderly in China. The prevalence rates of osteoporosis were extracted from middle-aged and elderly populations aged above 40 years, with 10 years for a group. The studies were col ected and analyzed using Stata 12.0.
RESULTS AND CONCLUSION:Thirty two articles were included with a total of 58 254 people (26 844 males and 31 410 females). The total prevalence rate of osteoporosis at the age above 40 years in China was 13.2%. The prevalence rate of males was 11.8%and that of females was 14.2%, and there was a significant difference between males and females (P<0.05). With aging, the prevalence rate of osteoporosis is increasing both in males and females, which increases gradual y in males but significantly elevates in females over 50 years old. In China, the detection rate of lumbar osteoporosis is higher in the northern region than the southern region, probably because of more heavy physical activities in the northern region;whereas, the detection rate of Ward’s osteoporosis is higher in the southern region than the northern region. In the recent 5 years, the prevalence rate of osteoporosis is significant increased in males and reduced in females compared with 5 years ago. These findings suggest that osteoporosis in Chinese is common and extensively distributed, and it is important to propagate knowledge of osteoporosis and prevent osteoporosis.

BACKGROUND:Lisfranc injury is rarely seen in clinical practice, with a low incidence and a high misdiagnosis rate. At present, open reduction and internal fixation is the major treatment, but there is little evidence available on the long-term fol ow-up fol owing injury and foot motor functions fol owing surgery. OBJECTIVE:To evaluate the change of foot functions after metal graft internal fixation in patients with Lisfranc injury. METHODS:Eighteen patients with Lisfranc injury were treated with internal fixation of metal grafts, such as Kirschner wire, screws and steel plate. At 6-8 weeks postoperatively, patients began to walk with crutches. After 1 year fol ow-up, the Footscan balance system and AOFAS scores were applied to evaluate the foot stability and function of patients. RESULTS AND CONCLUSION:After 1 year of internal fixation, al bone fractures were healed, the peak pressure of affected foot in the fourth metatarsal (M4) and the fifth metatarsal (M5) was significantly increased (P<0.05), and the impulse in the fifth metatarsal (M5) and mid-foot bottom (MID) was higher than the contralateral side (P<0.05). The AOFAS score of affected foot was 87.26 ± 21.13 points, the rate of excellent and good efficacy accounted for 88.9%. Internal fixation can rebuild Lisfranc complex stability, the body weight is transferred from the inside to the outside in the front foot, and the remaining pressure did not change significantly, thus the foot function is recovered satisfactorily.

Objective To evaluate the clinical effect of CYPHER TM (rapamycin) stent in treatment of left anterior descending (LAD) long lesion. Methods From October 2002 to April 2003, 65 patients with coronary heart disease (CAD) were treated with CYPHER TM (Cordis) stent and 65 stents were planted in 53 LAD lesions. Among the patients with LAD lesions, 42 cases were long lesions (≥20 mm). The length of lesion was from 20 mm to 50 mm (28.2?8.8 mm), the degree of stenosis before procedure was 88.9%?8.5%, and the vessel diameter before procedure was 3.0?0.9 mm. Three lesions were chronic total occlusion (CTO) lesion. Two lesions were in-stent restenosis. 12 lesions over 35 mm long were treated with two overlapped stents to cover the whole lesion. 30 lesions were treated with only one stent. We observed the procedure success and complication rates. The occurance of angina, myocardial infarction, sudden death, and the revascularization rate during the in-hospital and 6 months follow up. Results Immediate procedure success rate was 100% with residual stenosis of 5.0%?4.8%. All the lesions were covered fully by stents and the coronary flow reached TIMI grade three. No new dissection was observed in the optimal of stents. Only one patient was diagnosed as myocardial infarction after procedure and in-stent thrombolysis was proved by coronary artery angiography (CAG). During the 6 months follow-up, the symptom of angina was disappeared in 38 patients and alleviated in 4 patients. Eight patients received CAG in 3-6 months and no restenosis was observed. Conclusion Drug eluting stent (CYPHER TM) implantation is a safe and efficient therapy in treating patients with LAD long lesion, and short term follow-up results were better than the general coronary stents.

Objective To study the genome dynamics of Y. pestis and look for the relationship between its genome microevolution and niche adaption.Methods The DNA microarray combined with PCR was used to perform comparative genomic analysis of natural populations of Y.pestis.Results It was revealed that considerable genome dynamics of Y. pestis were the result of gene acquisition and loss in genome. We established a genomotyping system to group homologous isolates of Y. pestis, drew an outline of parallel microevolution of the Y. pestis genome, and established the link between the bacterial niche adaptation and genome microevolution.Conclusion The transmission, colonization and expansion of Y. pestis in natural foci are the results of its parallel, directional and gradual adaptation to the complex interactions among the environment, the hosts, and the pathogen itself.

Objective To identify the DNA tag sequences with the purpose of rapid and specific characterization of Y. pestis. Methods DNA microarray hybridization combined with PCR was used to perform genomic comparison between strains of Y. pestis and Y. pseudotuberculosis in order to screen and identify Y. pestis-specific genes. Results Twenty eight signature genes of Y. pestis were discovered. Three pairs of Y. pestis-specific primers were designed according to tag genes and proved to amplify the specific sequences of the target bacterium, showing no cross-reaction with the closely related Y. pseudotuberculosis and a large collection of genomic DNAs from other organisms. Conclusion DNA tag sequence is an ideal target for the rapid detection and identification of Y. pestis by PCR method.

Objective To study clinical factors about thrombosis in coronary stents.Methods We reviewed 571 patients who underwent percutaneous coronary intervention(PCI) and thrombosis in coronary stents happened in 5 patients.The clinical data and angiography results and anti-thrombus treatment about 5 patients have been studied.Results Thrombosis in stents had been happened in 6 lesions of 5 patients with acte coronary syndrom.3 lesions were C type.Drug-eluting stents had been deposited in 4 lesions.The cause of thrombosis in stent may be imcomplete stent expansion in 1 lesion and imcomplete apposition in 2 lesions and imcomplete treatment of anti-thrombu in 2 patients.Conclusion Our results show that thrombosis intrastent probably correlate with following factors:(1) Acue coronary syndrom.(2) Long lesion,imcomplete stent expansion, imcomplete apposition and drug-eluting stents.(3) Imcomplete treatment of anti-thrombus.

Objective To study the relationship between slow coronary flow and endothelium disorder.Methods One hundred and twelve patients with normal coronary angiography were divided into the slow flow group(n=38)and the normal flow group(n=84)in terms of their TIMI frame counts.Risk factors including sex,age,cholesterol,hypertension,diabetes,history of smoking and blood levels of endothelium-1,nitric oxide and interleukin-6 were compared between the 2 groups.Results Slow coronary flow was more common in male than in female(45 vs 39).Patients who smoked showed a higher incidence of slow coroany flow than non-smoker patients(P=0.010).The blood levels of ET-1(108.42?0.81 pg/mL vs 84.74?39.16 pg/mL,P=0.001)and IL-6(158.28?178.86 pg/mL vs 108.07?84.43 pg/mL,P=0.019)was higher in the slow flow group but with a lower levels of NO(35.66?12.28 ?mol/L vs 42.74?17.51 ?mol/L,P=0.032)when compare with the nomal coronary folw group.Conclusion Slow coronary flow is related to endothelium disorder but other risk factors should also be taken into consideration.

Objective To explore the theories of medical waste pyrolysis system composition, waste pyrolysis process, flue gas treatment process and etc.Methods The composition and process of pyrolysis treatment system and flue gas cleaning system were studied with the theories of configuration design, physico-chemical analysis, thermodynamics, fluid mechanics and etc.Results The schemes were put forward for on-board pyrolysis furnace and flue gas cleaning system.Conclusion On-board medical waste pyrolysis system can be used to treat the infectious waste in public medical emergencies, and thus is worth popularizing practically.

BACKGROUND:At present, the anatomic reconstruction of coracoclavicular ligament is a trend for the treatment of acromioclavicular joint dislocation. Endobutton plate is a new and effective surgical method found in recent years. Although the recent curative effect is satisfactory, as a method of internal fixation, its rigid fixation does not conform to the requirements of the biomechanics. Furthermore, a randomized control ed clinical study and systematic evaluation are absent.
OBJECTIVE:To systematical y evaluate clinical outcomes and safety between endobutton plate and the other surgical methods for treatment of acromioclavicular joint dislocation.
METHODCochrane (2014-01), PubMed (1966-01/2014-03), Medline (1966-01/2014-03), EMbase (1984-01/2014-03), CNKI (1979-01/2014-03), VIP (1989-01/2014-03) and Wanfang (1989-01/2014-03) databases were searched by computer. Six Chinese journals about orthopedics were searched by hand. References of relevant literatures were searched. Randomized control ed trials that were related to different surgical methods for the treatment of acromioclavicular joint dislocation were col ected. In accordance with inclusion criteria, some literatures were included and their qualities were assessed strictly. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Col aboration.
RESULTS AND CONCLUSION:Final y 7 published studies with randomized control ed trials met al the inclusion criteria. A total of 359 patients were included, containing 152 cases of endobutton plates fixation, 149 cases of clavicle hook plate fixation, and 58 cases of screw fixation. Except two researches addressed the comparison among three surgical ways, the remaining were about two ways. Meta-analysis showed that the excellent rate was better in endobutton plates fixation than in clavicle hook plate fixation (P=0.0002) and in screw fixation (P=0.009). Compared with other fixation methods, there were significant differences in shoulder joint pain (P=0.01), but no significant difference was detected in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection (P=0.44, P=0.10, P=0.37, P=0.21, P=0.96). Results indicated that, the efficiency of endobutton plates fixation for acromioclavicular joint dislocation was better than clavicle hook plate fixation and screw fixation, and caused less shoulder pain than clavicle hook plate fixation. There was no significant difference in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection among the three methods. Due to the limited number of cases in this study, the multicenter, large-sample and long-term clinical randomized control ed studies are needed to increase the strength of the evidence.