Objective To investigate the anatomical character and clinical application value of external malleolus periosteum bone flap pedicled with facia and external malleolus anterior artery. Methods Applied anatomy was studied with 10 adult corpse specimen after artery perfusion,observed the origin.trackway,and measured the external diameter and major vessel's length of external malleolus anterior artery,observed the composition of external malleolus artery net,and completed the performance in clinic in 10 patients and followed up for 6 months～6 years. Resultes The bone flap had abundant blood-supply,its pedicle was long enough for transfer,little injury to donor,the surgical procedure was easy to manipulate,and was used in clinic to treat talus fracture in 9 cases (fresh 5 and old 4) and old tibia fracture in 1 case,10 cases were involved with satisfactory outcome. Conclusion External malleolus periosteum bone flap pedicled with fascia and external malleolus anterior artery is a good new donor for the patients with fracture of talus or lower tibia,especially ununited case or osteonecrosis.

Objective We investigated urinary incontinence (UI) among patients of the Gynecological Department of Renmin Hospital of Wuhan University,to observe characteristics of women with UI in our province,and to analyze preliminary factors affecting their treatment.Methods We evaluated 15 300 patients treated for UI from August 2009 to April 2011,using site information and questionnaires.We also compared them to 66 825 other gynecology outpatients at our hospital over the same period.Results We found that the incidence of UI tended to increase with age,and was associated with body mass index,parturition,and surgery history.But 54.63％ (8358/15 300) of them refused surgical treatment.Of these 8358 patients,29.78％ (2489/8358) because of economic factors,25.83％ (2159/8358) because of mental stress,and 24.30％ (2031/8358) because of lack of faith in the efficacy of surgical treatment,20.09％ (1679/8358) did so because of knowing little of the disease.Conclusions UI is inconvenient to patients,and seriously affects their physical and mental health. Many patients refuse surgical treatment.Medical staff should attempt to educate patients better with regard to treatment,and to offer them help to improve the quality of their lives.

A mild rapid method for the determination of Pb in grain was established by diluted acid extraction and direct sampling detection with graphite furnace atomic absorption spectrophotometer(GF-AAS). Some factors, such as the grain size, nitric acid concentration, extraction time, solid, liquid proportion, and the instrument conditions were optimized. The results indicated that, at room temperature, the extraction rate of Pb in grain by diluted nitric acid was between 92. 14% and 94. 75%, and the average recoveries of Pb in grain extract reached 91. 65%-94. 58%, the precision of method was less than 5%, and the method detection limits and quantification limits were 0. 64 μg/L and 2. 14 μg/L, respectively, meanwhile, the extraction time was shorten to no more than 30 min. Compared with the results pretreated by microwave digestion and determined by GF-AAS, the detection values obtained by diluted acid extraction had no significance difference (p<0. 1).

ObjectiveTo investigate the changes and functions of T lymphocyte subsets,immune globulin and complement in children with mycoplasma pneumoniae pneumonia(MPP) on different disease stages.MethodsThe levels of T Iymphocyte subsets of CD3,CD4,CD8 and immunoglobulin ( IgG,IgA IgM),and complement ( C3,C4 ) in the peripheral blood were detected on acute and recovery stages in 28 children with MPP by flow cytometry and immune nephelometry.Twenty-five healthy children were recruited as control group.ResultsAmong these subjects of MPP children on acute stage,the levels of CD3,CD4,CD8,and CD4/CD8 in the peripheral blood were (58.71 ± 11.63)％,(32.36 ± 8.06)％,(28.19±6.23 ) ％ and 1.15 ± 0.41 respectively,and on recovery stage,the levels of CD3,CD4,CD8,and CD4/CD8 were (61.29 ±10.17)％,(34.14 ±7.22)％,(26.47 ±6.01)％,and 1.29 ±0.37 respectively.Both on acute stage and on recovery stage of MPP children,the levels of CD4,CD4/CD8 were significantly lower than those in control group [ (39.53 ± 6.16 ) ％,1.83 ± 0.49 ],and CD8 was significantly higher compared to thecontrol group( 1.83 ± 0.49 ),P＜0.01.CD3 were lower than that in control group [ (63.03 ± 12.32) ％ ] on acute stage (P＜0.01 ),and no significant difference on recovery stage (P＞0.05).During the acute stage of MPP,IgG [ ( 14.50 ±3.86) g/L] and IgM [ ( 1.67 ±0.56) g/L] were obviously higher than those in control group [ (7.92 ± 2.62 ) g/L,( 1.06 ± 0.32 ) g/L,P＜0.01 ],and C3 [ ( 0.83 ± 0.42 ) g/L ] were obviously lower compared to the control group [ ( 1.37 ± 0.33 ) g/L,P＜0.05].There were no significant differences of IgA and C4 between MPP and control groups ( P＞0.05 ).ConclusionChildren with MPP had celhilar immune and humoral immune disorders.Through the detection of T lymphocyte subsets,immunoglobulin and complement,it will be helpful to judge the effectiveness of clinical treatment,which provides a theoretical basis for the clinical application of immune regulators.

In order to study the character of periodontal ligament cells (PDLCs) attaching on commercially pure titanium (cpTi) by morphology and metrology on the early stage (24 h), 1 x 10(5)/ml PDLCs in 2 ml culture medium were seeded on cpTi discs fixed in 24-well culture plates. Morphology of cell attachment was observed by contrast phase microscope, scanning electron microscope (SEM) and fluroscence microscopy. Cell adhesion was analyzed by MTT at 0.5, 1, 2, 4 h respectively. PDLCs could attach and spread on cpTi discs. SEM showed that PDLCs had pseudopod-like protuberance. PDLCs showed different attaching phases and reached saturation in cell number at 2 h. It was concluded that PDLCs had good biocompatibility with cpTi, and showed a regular and dynamic pattern in the process of attaching to cpTi.
Biocompatible Materials/pharmacology ; Cell Adhesion ; Cell-Matrix Junctions ; Cells, Cultured ; *Dental Implants ; Periodontal Ligament/*cytology ; Surface Properties ; Time Factors ; Titanium/*pharmacology

Objective To evaluate intra-and interatrial synchronization in patients with paroxysmal atrial fibrillation (PAF) by dual gate Doppler and discuss the predictive value of atrial asynchrony for detecting PAF.Methods Twenty-nine patients with PAF as AF group and 24 healthy volunteers as control group underwent echocardiography.The time interval of the onset of a'wave between mitral annular septal and lateral site was T1 by dual gate Doppler,which was used to evaluate left atrial synchronization.The time intervals from the onset of a'wave at tricuspid annular right ventricular free wall site to a'wave at tricuspid annular septal site and mitral annular lateral site were T2 and T3,which were respectively used to evaluate right atrial and interatrial synchronization.The greater time interval predicted the worse synchronization.Compared these indexes between two groups,the most valuable index was obtained and combined with left atrial volume index (LAVI) to predict PAF,its optimal values were found out by ROC curve.Results ①There were no significant differences in many other basic indexes between two groups (P ＞0.05).However,compared with control group,the ratio of early diastolic transmitral flow velocity (E) and mitral annular velocity of septal site (e'),the diameters and volume indexes of atria were significantly increased in AF group.②T1,T2 and T3 (standardized before and after) increased significantly in AF group (P ＜0.01).Standardized T1 had the largest area under curve (AUC) for detecting PAF.The AUC of standardized T1 and LAVI were 76.6％ and 84.1％.Standardized T1 ≥29.55 ms and LAVI≥ 21.60 ml/m2 were combined for detecting PAF (sensitivity 82.8 ％,specificity 79.2％,AUC 87.1％).③ Standardized T1 was positively correlated with age,left atrial systolic diameter,LAVI,RAVI and E/e'(P＜ 0.05).Conclusions Patients with PAF have worse intra-and interatrial synchronization and left atrial asynchrony can provide predictive value for detecting PAF.Dual gate Doppler is expected to be a new technique for evaluating intra-and interatrial synchronization accurately and detecting the risk of AF.

Objective To determine the ameliorative effects of Junzhi beverageⅠon neurobehavioral functions in subjects exposed to long-term sustained work.Methods Forty male students of a military institution were randomized into control group ( n=20 ) and the intervention group ( n=20 ) .All the subjects were exposed to 10-hours′high intensity mental work continuously (8∶00-18∶00).At 12∶50, the intervention group drunk a bottle of water with Junzhi beverageⅠ, but the control group drunk water of the same volume only.At 17∶00, neurobehavioral functions of all the subjects were tested by neurobehavioral core test battery (WHO-NCTB) and attention span test(AST).Results According to the results of WHO-NCBT, after 10-hours′continuous mental work,the profile of mood state in the intervention group was more stable than in the control group with lower scores in negative mood and higher scores in positive mood.Meanwhile, some of the neurobehavioral indexes were also found to be significantly improved, including shortened mean time of simple reaction and decreased error reaction rate, enhanced digit span backward, higher scores in Beton test , digit symbol test, Santa Ana practice hand and correct dot number (P<0.05).In addition, higher scores were obtained in the intervention group in AST(P<0.05).Conclusion Junzhi beverageⅠ can significantly improve the neurobehavioral function under sustained mental work conditions, which suggests that the beverage has the potential to postpone mental fatigue protect and enhance cognitive function.

Objective:To explore the monitoring value of left ventricular functional parameters obtained by bedside ultrasound combined with clinically relevant indicators in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:A retrospective study was conducted. A total of 24 patients receiving VA-ECMO adjuvant support in Renmin Hospital of Wuhan University from June 2018 to January 2020 were selected. The bedside ultrasound was performed on the first day of ECMO support, the day before weaning, the clinical indicators before weaning were obtained. The differences in clinical indicators and the left ventricular functional parameters between the two groups of whether weaning successfully were compared; univariate Logistic regression analysis was used to screen out the related factors affecting weaning.Results:Sixteen patients were successful weaned and 8 patients failed. Compared with the weaning failure group, patients in the weaning success group required less continuous renal replacement therapy (CRRT, cases: 4 vs. 6, P < 0.05), mean arterial pressure (MAP) before weaning was higher [mmHg (1 mmHg = 0.133 kPa): 84.64±9.55 vs. 62.30±8.79, P < 0.05], and the pulse oxygen saturation (SpO 2) was also higher (0.966±0.670 vs. 0.866±0.061, P < 0.05), while vasoactive-inotropic score (VIS), serum creatinine (SCr) and serum lactic acid (Lac) were lower [VIS score: 7.27±1.42 vs. 16.93±8.52, SCr (μmol/L): 123.60±83.64 vs. 213.10±117.39, Lac (mmol/L): 1.94±0.91 vs. 5.62±5.48, all P < 0.05]. Univariate Logistic regression analysis showed that the MAP, VIS, SCr, Lac, SpO 2 before weaning were the related factors affecting weaning [odds ratio ( OR) were 0.306, -0.740, -0.011, -0.632, -4.069; 95% confidence interval (95% CI) were 1.065-1.732, 0.235-0.899, 0.979-0.999, 0.285-0.992 and 0.001-0.208; P values were 0.014, 0.022, 0.038, 0.047, 0.002]. In the weaning success group, left ventricular ejection fraction (LVEF), velocity of mitralannulus in systolic (LatSa), maximum flow velocity of aortic valve (AV-Vmax), velocity-time integral (VTI), left ventricular global longitudinal strain (LVGLS), left ventricular global longitudinal strain rate (LVGLSr) were all increased on the day before ECMO weaning compared with the first day of ECMO support [LVEF: 0.40±0.05 vs. 0.28±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.62±1.02, AV-Vmax (cm/s): 104.81±33.98 vs. 64.44±16.85, VTI (cm): 14.56±3.11 vs. 7.96±1.98, LVGLS: (-8.95±2.59)% vs. (-5.26±1.28)%, LVGLSr (1/s): -0.48±0.11 vs. -0.29±0.09], whereas the ECMO flow was significantly reduced (L/min: 1.46±0.47 vs. 2.64±0.31), the differences were statistically significant (all P < 0.05). There was no significant difference in left ventricular functional parameters between the first day of ECMO support and the day before ECMO weaning in the weaning failure group. Compared with the weaning failure group, the weaning success group had higher LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr on the day before ECMO weaning [LVEF: 0.40±0.05 vs. 0.26±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.31±1.03, AV-Vmax (cm/s): 104.81±33.98 vs. 67.67±18.46, VTI (cm): 14.56±3.11 vs. 7.75±2.77, LVGLS: (-8.95±2.59)% vs. (-4.81±1.81)%, LVGLSr (1/s): -0.48±0.11 vs. -0.30±0.10, all P < 0.05] and lower ECMO flow (L/min: 1.46±0.47 vs. 2.20±0.62, P < 0.05). Conclusion:Bedside echocardiographic left ventricular function parameters (LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr) combined with clinical indicators (MAP, VIS, SCr, Lac, SpO 2) were helpful to evaluate the therapeutic effect of patients receiving VA-ECMO support and can provide important guiding value in the selection of VA-ECMO weaning timing and the judgment of prognosis.

Objective To discuss effect of fasting and taking food on hemostasis effect of patients with gastric ulcer and bleeding. Methods 160 patients with gastric ulcer and bleeding were divided in-to the experimental group and the control group, the experimental group was allowed to take lower ho-moiothermy water gruel (liquid), the control group was required absolute fasting (not medication), until bleeding stop. The two groups adopted identical treatment and nursing. The lienable stomach tube was placed respectively, everyday pH value monitor and occult blood test were carried out by taking out gas-tric juice when fasting and 2 hours after meals. Continuous monitoring tests continued till occult blood test of gastric liquid became negative for 3 times. Stool was kept for occult blood test, at the same time the gastrointestinal tract symptom and bleeding condition were observed, routine blood test was carried out one every other day. The data underwent statistical analysis with SPSS13.0 statistics software package, compari-son between two groups used t test. Results The inner stomach pH value of the experimental group in-creased obviously, the average pH value and percentage of pH above 4 was evidently higher than those of the control group. The time of occult blood test of gastric liquid and stool turning to negative in the experi-mental group was shorter than those of the control group. Conclusions Taking food can elevate pH of gastric liquid, reduce damage caused by gastric acid to gastric mucosa, thus hasten hemostasis process and promote healing.

Objective To explore the effect of lipid raft on cervical cancer cell growth and its mechanisms Methods HeLa cells in logarithmic phase were divided into three groups including control group, lipid raft interference agent group,and NADPH oxidase inhibitors group.Cells were treated with fre sh medium,3 μmol/L Apocynin and 1 mmol/L M-beta CD, respectively, for 24 h.Cell survival rate was detected using the MTT method, and the HIF-1α level was examined by Western-blot. Results Cell growths of the lipid raft interference agent group and NADPH oxidase inhibitors group were significantly slower than control group,(0.612±0.051 vs 0.984±0.034,0.591 ±0.074 vs 0.984±0.034,t=4.062,P＜0.05).HIF-1α expression in the lipid raft interference agent group and NADPH oxidase inhibitors group was also significantly reduced compared with control group (1.79±0.14 vs 2.56±0.22 and 1.54±0.12 vs 2.56±0.22) and the difference was significant (t=2.423,P＜0.05). Conclusion Lipid raft-NADPH oxidase pathway may activate HIF-1α and downstream protocarcinogenic gene expression to promote the growth of cervical cancer cells. The inhibitors of lipid raft and NADPH oxidase may become a new research direction for cervical cancer chemotherapy.