The anterior cruciate ligament (ACL) injury in sports is a common knee joint injury.It is widely accepted to reconstruct ACL under arthroscopy with autologous patellar ligament or popliteal ligament fixed in tibial or femoral tunnel with interference screws.Interference screws are widely used as intra-articular fixation devices in ACL reconstruction.The ideal materials for interference screw provide rigid fixation of graft with high mechanical strength,long-lasting stiffness and the bioactivity to stimulate osteointegration and tendon-bone healing.Current interference screws are made of metals and bio-absorbable polymers.Metallic interference screws provide high mechanical strength and stiffness for tendon graft fixation,but require a second surgery for removal.Bioabsorbable interference screws made of polymers avoid second surgery for removal,but have lower mechanical strength and might cause aseprtic inflammation during its degradation as well as screw slip,tunnel enlargement and many other complications.Magnesium (Mg) has been investigated as a novel and potential biomaterials for biodegradable interference screws.Mg is essential nutrient element and has good biocompatibility.Its mechanical strength and related stiffness are much higher than that of biodegradable polymers and are close to cortical bone.Furthermore,the degradation rate of Mg in vivo could be modulated via techniques such as alloying.In previous studies,the relationship between screw design and its pull-out force has been investigated,based on which the design of interference screw is optimized.The mechanical properties (the ultimate load to failure and the related stiffness) of interference screws proved to be higher than that of bioabsorbable interference screws sharing the same design both in vitro and in vivo.Furthermore,Mg performs good biocompatibility without severe intra-articular inflammatory reactions,as well as unique bioactivities to promote osteointegration,mineral deposition and the regeneration of fibrocartilaginous entheses.The present study reviews the researches of Mg interference screws both in vitro and in vivo,gives reference for further research and has great importance for the application of Mg interference screws in ACL reconstruction.

Objective To discuss action of microelement Se in serum and milk of gestational diabetes melli-tus parturient.Methods The serum and milk samples were collected from 50 gestational diabetes mellitus parturient and 50 healthy parturient.The selenium contents were detected by radioimmunoassay.Results The serum Se content in gestational diabetes mellitus parturient was obviously lower than that in healthy parturient(t =2.128,P <0.05). The milk Se content in gestational diabetes mellitus parturient was lower than that in healthy parturient(t =1.014, P >0.05).Conclusion Selenium deficiency persisted in gestational diabetes mellitus parturient.But Selenium defi-ciency did not exist in milk of gestational diabetes mellitus parturient.So encouraging breastfeeding,elevating selenium containing food intake,and supplement the selenium preparation properly maybe prevent and delay type 2 diabetes in gestational diabetes mellitus parturient.

Objective To measure the cancellous bone contents at different parts of the humeral heads of different ages and genders for data helpful for humeral head fixation.Methods Thirty-six patients with proximal humeral fracture were selected for this study who had been treated at our department with locking proximal humerus plate from June 2008 to April 2010.They were 18 men and 18 women,aged from 20 to 86 years (average,51.6 years).They were grouped according to age:group A ( ＜ 40 years),group B (40 to 60 years),and group C (＞ 60 years).A GE Sensation 16 CT scanner (GE Healtbcare,USA) was used to scan both of their affected and healthy humeral heads preoperation,with slices one mm thick.The bone density of cancellous bone was assessed by the CT value expressed in Hounsfield units.The maximum,minimum,and mean CT values were calculated for the cancellous bone in the humeral head in each image.CT images were processed by computer with custom software (Xiphoid 1.3,Image J 1.4g and Image-Pro Plus 6.0).All the data were analyzed with SPSS16.0.Results We found 4 weak point.s at the cortical bone of proximal humerus,correspondent with the 4 clinic CT types of proximal humeral fracture.The cancellous bone was the densest in the medial humeral head.The mean cancellous bone content was significantly lower in group C than in group A and B( P ＜ 0.05).There was a significant difference between men and women in group A in the BMD of cancellous bone ( t =4.744,P =0.001 ).Conclusions The cancellous bone content in the humeral head is related with age and gender.Since there is more cancellous bone in the medial part than in other parts of the humeral head,it is a reliable part for humeral head fixation.

Objective To report the anatomical study and clinical application of the medial sural artery pertorator flaps. Methods The anatomical study involved 12 fresh adult cadaver lower legs, the arteries of which were perfused with suspensions of lead oxide and gelatine. The bifurcation, location, length, diameter and blood territories of the medial sural artery and its perforating vessels were recorded by dissection, angiography and photography. The integument of the leg was dissected and ridiographed. The tendency of the vessels was analyzed, the surface areas of cutaneous territories and perforator zones were measured and calculated with Photoshop and Scion Image. With the aid of anatomic study, a series of five clinical cases was reported, including five free medial sural flaps for ipsilateral hand reconstruction. Results There was at least one perforating vessel in the medial sural areas of the specimen. A mean of 2.1 perforators was noted over the medial gastrocnemius muscle. The perforating vessels from the medial sural artery clustered about 9 to 18 cm from the popliteal crease, 1 to 5 cm from the posterior medial line. Their diameter was (1.03±0.22)mm at the deep fascial level. The average vascular territory on the sural area was (107.5±23.9)cm2, and the average supplying area of single perforator was (58.3±17.0)cm2. All the transferred free flaps taken in the 5 clinical cases survived uneventfully. All the patients were followed-up from 6 months to 12 months. The appearance of flaps and the function of the limbs were satisfied. Conclusion The standard method for the study of perforator flap is the lead oxide-gelatin technique. It is the anatomic basis that there are perforating musculocutaneous vessels on the medial gastrocnemius muscles constantly. The free medial sural perforator flap has the advantage of good appearance. It is the safe and suitable choice in the cases when a medium or small-sized flap is required for resurfacing hand injuries.

Objective To investigate the clinical significance of peripheral blood parameters including immature reticulocyte fraction (IRF) in monitoring the hematopoietic recovery of patients with acute myeloid leukemia aftcr receiving consolidation chemotherapy with high dose cytarabine (HDAC).Methods The peripheral blood parameters,including absolute neutrophil (ANC) and platelet (Plt) counts as well as IRF,were measured by Sysmex XE-2100 automated hematology analyzer before and after consolidation chemotherapy with HDAC in 30 patients with acute myeloid leukemia.These peripheral blood parameters were further statistically analyzed and compared.Results Following consolidation chemotherapy,the median time to recovery for ANC,Plt and IRF was (9.2±2.5) days,(11.3±3.7) days and (5.0±2.6) days,respectively.In comparison with ANC and Plt recovery,IRF showed significantly early recovery (P ＜ 0.05).Additionally,ANC raised preceding Plt recovery (P ＜ 0.05).However,the median recovery time of ANC,Plt and IRF showed little difference among these patients further subgrouped according to FAB and risk based classification (P ＞ 0.05).Conclusion IRF is an early indicator for the hematopoietic recovery of patients with acute myeloid leukemia following consolidation chemotherapy with HDAC,which could provide important clinical information to evaluate therapeutic efficacy.

Objective To analyze the problem existing in the process of health records informatization con-struction and explore solution on the basis of situation of health record informatization in Yanta district of Xi'an city. And to provide bases for acceleration of residents'health records informatization construction in Xi'an.Methods Send 10 investigators to study and investigate the hospital information management system of 10 full-time public universities in Yanta district.Results There were a total of 25 711 faculties in 10 full-time public universities and 19 809 facul-ties had established electronic files,the filing rate was 77.04% A.On the whole,it seemed that the teaching staff in the filing rate(78.91%)was higher than that of the retired workers filing rate(73.78%),the two groups had statisti-cally significant difference(χ2 =88.164,P <0.05)B.Conclusion Xi'an Yanta district university faculty of electron-ic health records has exceeded the national average level,but there are still many problems need to be improved.We should strengthen government investment,the establishment of the region's unified information management standards, increase publicity and education efforts,and actively create the region's resource information sharing platform.

【Objective:】 To understand the current status and problems of the doctor-patient relationship under the family doctor contract service system through the investigation on residents contracted by community family doctors, and to provide reference for constructing harmonious doctor-patient relationship and promoting the healthy operation of the family doctor contract service system. 【Methods:】 A questionnaire survey was conducted on 1 655 residents of a certain university community in Xi’an from January to February 2023 who completed family doctor contract services in 2022. Through the general situation of signed residents, the willingness of signed family doctors, and the satisfaction and opinions with signed family doctors’ services, this paper investigated the current status of the doctor-patient relationship and proposed corresponding improvement strategies. 【Results:】 A total of 856 residents(52.68%) were willing to sign the contract, 322 residents(19.82%) were unwilling to sign the contract, 397 residents(24.43%) expressed indifference, and 50 residents(3.07%) abstained from signing the contract. There was no statistical difference in service satisfaction between residents of different genders(P=0.292). The satisfaction of working staff aged 40-60(72.33%) was higher than that of retirees aged over 60(61.05%, P<0.001). The satisfaction of those with bachelor’s degree or above(58.23%) was higher than that of those with bachelor’s degree below(51.77%, P=0.008). The satisfaction of individuals living alone(70.21%) was significantly higher than that of non-solitary individuals(54.35%, P<0.001). The overall satisfaction score of contracted residents with contracted services was(4.48±0.14) points, including 4.31 points for satisfaction with service methods, 4.47 points for satisfaction with service attitudes, 4.52 points for satisfaction with service content, and 4.60 points for satisfaction with service effectiveness. 【Conclusion:】 Most community residents have a positive attitude towards family doctor contract services. Improving service satisfaction and strengthening doctor-patient communication are feasible ways to improve grassroots doctor-patient relationships and promote the operation of the family doctor contract service system.

Interest teaching method aims to inspire students' initiative and inquiry in learning.In the teaching process,we used some teaching methods including class lead-in,relevant extracurricular books and websites,scene representation,lectures on special content and arrangements of the review writing.It is important to maintain students' motivate and interest in learning human parasitology,therefore,we should no longer make students passively accept but the initiatively make inquiry learning.

Objective To evaluate the value of reducing radiation dose with decreased size of ECG-pulsing windows and influence on image quality in dual-source CT coronary angiography. Methods 120 patients with stable heart rate(HR) were divided into four groups according to HR and the rang of ECG-pulsing windows in dual-source CT coronary angiography: HR ＜ 70 bpm and 61% ～ 77% R-R interval of ECG-pulsing windows, HR ＜ 70 bpm and 25% ～ 80% R-R interval of ECG-pulsing windows,HR ＞ 80 bpm and 31% ～47% R-R interval of ECG-pulsing windows, and HR ＞ 80 bpm and 25% ～ 80%R-R interval of ECG-pulsing windows was employed, respectively. The radiation dose parameters were recorded and image quality scores were performed. The image quality and radiation dose between two slow HR groups and between two fast HR groups were compared respectively. Result The effective doses were (7.06 ± 2. 13 ), ( 11.34 ± 3.65 ), ( 6. 67 ± 1.97 ) and ( 9. 92 ± 3. 15 ) mSy for four groups, respectively.The effective dose was decreased by 37.74% for slow HR and by 32. 76% for fast HR using narrow ECG-pulsing windows. There was no difference on image quality between two slow HR groups and two fast HR grouvs. Concluslons The proper application of narrow ECG-pulsing windows can reduce radiation exposure significantly to stable slow or fast HR patients in dual-source CT coronary angiography withont sacrificing the image quality.

Objective To determine the vitamin D status in children with sepsis/severe sepsis in pediatric intensive care unit (PICU) in order to explor the association between vitamin D status and clinical outcomes,in turn to provide evidence for optimizing nutrition support.Methods It was a prospective,observational,multi-center study,carried out in patients with sepsis/severe sepsis from March 1,2013,to March 30,2014,in the PICUs of three tertiary-care children's hospitals.Total serum 25-hydroxy vitamin D [25 (OH) D] was measured by using an enzyme-linked immunosorbent assay at admission.The association of vitamin D status at admission with length of PICU length of stay,total hospital stay,in-hospital mortality,28-days mortality and costs were analyzed.Results A total of 194 patients includng 117 boys (60.3％)and 77 girls (39.7％) were enrolled.There were 96 patients with sepsis and 98 with severe sepsis.The mortality on discharge and 28 days were 6.7％ and 24.2％ respectively.The median vitamin D level was 9.79 ng/mL (5.32,18.46) at admission.Of them 77.8％ (151/194) had vitamin D deficiency and 50.5％ (98/194) had severe vitamin D deficiency.Patients with severe vitamin D deficiency,had higher mortality on discharge (P =0.011).Vitamin D status had no significant correlations with 28 days mortality,length of PICU stay,total hospital stay and costs.Conclusions More than three-quarters (77.8％) of children with sepsis/severe sepsis in PICUs had Vitamin D deficiency.Patients with severe vitamin D deficiency at admission had higher risk of mortality at discharge.