[Objective]To research the biomechanical influence of posteriomedial fractures on proximal femur.[Method]Three dimensional finite element models of intact and osteotomied proximal femurs were established from computerized tomographic(CT)scanning images,and finite element analysis was undertaken.[Result]The maximum equivalent stress was located at the anteriomedial of the defection of the proximal femur.The stress of femoral neck,as well as the medial and lateral femoral cortex was not significantly changed after isolated lesser trochanteric fracture.However,with half of the medial cortex involved,the stress of the medial and lateral femur increased by 47% and 12%,respectively.If the entire medial cortex was involved,the stress of medial and lateral femur increased by 247% and 66%,respectively.[Conclusion]Different types of posteriomedial fragments have different effects on the stress distribution and quantity of proximal femur.When treating intertrochanteric fractures using dynamical hip screw,the fragments should be differently treated based on its types considering for biomechanical effects.

Objective To report the results of the surgical treatment of cervical spondylotic myelopathy(CSM) secondary to athetoid cerebral palsy and clarify the characteristics and the principle of treatment of the disease. Methods The age of the patient, segments of vertabrae involved and operated upon, results and complications of 32 cases with CSM secondary to athetoid cerebral palsy were statistically analyzed and compared with 93 patients who had isolate CSM operatively treated at the same time. Results 1)The average age of the patients in the group of CSM secondary to athetoid cerebral palsy was 37.94 years,and in the group of isolate CSM was 52.48 years, with significant statistic difference(P

Osteomyelitis (OM) is still a major problem for orthopedists. Numerous studies have shown that genetic factors may play an important role in the pathogenesis of OM. As a third generation genetic marker, single nucleotide polymorphisms (SNPs) have received increasing attention from scholars who are studying genetic susceptibility to OM. In-depth research on the SNPs of susceptibility genes will help to explore new strategies for prevention, diagnosis and treatment of OM. This article reviews the research advances concerning gene SNPs and OM susceptibility.

OBJECTIVETo investigate the clinical experiment of cortical screw in the treatment of tibiofibular syndesmosis separation together with ankle fractures.

METHODSFrom March 2008 to May 2012,42 patients with tibiofibular syndesmosis separation were treated with cortical screw, including 20 cases in the left and 24 cases in the right. All the patients had closed injury. According to Lauge-Hansen classification, there were 18 cases of supination-external rotation, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III, 6 patients with injuries belong to type IV; 14 cases of pronation-external rotation, in which 6 patients with injuries belong to type III, 8 patients with injuries belong to type IV; and 12 cases of pronation-abduction, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III. According to injury of ankle, 4 patients had injuries in one ankle, 28 patients had injuries in 2 ankles, and 12 patients had injuries in 3 ankles. All the patients were diagnosised definitely in sight of medical history, checking-up, iconography. The clinical effects were evaluated based on Baird-Jackson score and activity degree of ankle.

RESULTSAll the patient were followed up, and the duration ranged from 11 to 23 months, with an average of 15.7 months. No postoperative wound infection, nonunion, and tibiofibular syndesmosis separation again and other complications occurred. Postoperative Baird-Jackson score exhibited 91.56 ± 6.26 (75 to 99), and 26 patients got an excellent result, 10 good, 6 poor and 2 bad. One patient had nail broken after operation,and got good function after removing broken nail without external fixation. Other 1 patient had osteoarthritis to 1 degree, and got better result with the treatment of physical therapy and intra-articular injection.

CONCLUSIONCortex screw is the effective treatment for tibiofibular syndesmosis separation. Clear diagnosis, delicate operation and postoperative reasonable functional exercise are primary factor of prognosis.

Adult ; Ankle Fractures ; surgery ; Ankle Joint ; surgery ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To investigate the feasibility of congenital cytomegalovirus (CMV)infection screening by saliva polymerase chain reaction.Methods From November 1,2010 to February 29,2012,6733 newborns born in Changzhou Maternal and Child Health Care Hospital were enrolled.Saliva samples (0.2 ml) were collected within 3 days after birth,CMV-DNA was detected by real time-polymerase chain reaction and hearing screening was done with EroScan transient-evoked otoacoustic emissions at the same time.The positive rate of congenital CMV infection screening was calculated and clinical manifestations were analyzed.Chi square test was applied to statistical analysis.Results Totally 6733 newborns were screened and 107 of them were found to be positive with CMV DNA,the positive rate was 1.59％ (107/6733),among which 88 were asymptomatic (82.2％) and 19 were symptomatic (17.8 ％).The major clinical manifestations of the neonates with positive CMVDNA were pathological jaundice (13 cases),hepatomegaly (5 cases),granulocytopenia,thrombocytopenic purpura,anemia and small for gestational age (two cases each).Fourteen newborns had only one major clinical manifestation,three newborns had two major clinical manifestations and two newborns had three major clinical manifestations.There was no statistical difference between newborns with positive and negative CMV DNA on hearing screening [hearing loss in one ear:8.4％ (9/107) vs 5.8％ (382/6626); hearing loss in two ears:3.7 ％ (4/107) vs 2.4 ％ (159/6626),x2 =2.776,P=0.241].Conclusion It is feasible to screen congenital CMV infection with saliva sample.

Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.

? AIM: To investigate the differences between synoptophore and triple prism strabismometry and its possible cause.?METHODS: There were 347 patients with horizontal concomitant strabismus involved, in which 76 patients were esotropia, 37 patients were male while 39 were female, with average age of 13. 27 ± 7. 77 years old. There were 271 patients with exotropia, 131 cases were male while 140 were female, with average age of 15. 43 ± 8. 42 years old. All the patients were examined by synoptophore and prism plus shaded strabismometry in a long distance of 6m. Datas were analyzed by SPSS 17. 0.?RESULTS:In the exotropia patients, the conversions of circular degree(°) and prism degree(△) were:1°=0. 29△ ~1. 78△, which was statistically significant with intermittent strabismus (P=0. 001). While in the esotropia patients, the conversions were:1°=2. 01△ ~2. 15△.?CONCLUSION: The diversity between the two methods is enlarged with the increase of squint angle for exotropia patients. While in esotropia patients, the diversity decreased with the increase of squint angle. Synoptophore equipped with +7. 00D, defects of the triple prism itself and proximal convergence during exam may be the reasons for the diversity.

Aim To establish a hepatic carcinoma cell line with stable voltage-gated chloride channel 3 ( ClC-3 ) gene silencing through the lentivirus-mediated short-hairpin RNA ( shRNA ) method and investigate the effects of gene silencing on invasion and migration. Methods Three lentiviral vectors coding shRNA tar-geting ClC-3 gene were constructed, the recombinant plasmids were packaged into mature lentivirus by 293FT cells, and then the lentiviruses were harvested, concentrated and titrated. MHCC97H cells were infec-ted with the recombinant lentiviruses and then were se-lected to obtain cell lines stably expressing ClC-3 shR-NA. The efficiency of ClC-3 mRNA and protein ex-pression interference were determined by real-time flu-orescence quantitative PCR and Western blot, respec-tively. The effects of ClC-3 gene interference on inva-sion and migration of MHCC97 H cells were performed by Transwell chamber assays with or without Matrigel and cell scratch assay. Results The recombinant lentiviral vectors were successfully constructed and four lentiviruses were acquired after packaged by 293 FT cells. One negative control cell line and three cell lines with ClC-3 gene interference ( MHCC97 H/shClC-3-1 , shClC-3-2 and shClC-3-3 ) were successfully construc-ted after MHCC97 H cells were infected with lentivirus-es. The expression level of ClC-3 mRNA and protein in three ClC-3-silenced cells were obviously lower than the negative control cells ( P <0. 01 ) , MHCC97 H/shClC-3-2 cells showed the greatest inhibition of ClC-3 mRNA and protein expressions. As compared with the negative control cells, the ClC-3 gene interference sig-nificantly decreased invasion and migration of MH-CC97 H cells in vitro ( P <0. 01 ) . Conclusion The hepatic carcinoma cell lines with stable ClC-3 gene si-lencing were successfully established and the ClC-3 gene interference could significantly inhibit invasion and migration of MHCC97H cells.

Objective To investigate the use condition of Chinese decoction pieces in Beijing TCM Hospital of Capital Medical University. Methods Excel was used to analyze the data collected from the hospital, including transfer, storage, and income and expense data of decoction pieces from 2010 to 2013. Results Workload of transfer of Chinese decoction pieces increased every year, and the staff were heavily loaded. Compared with western medicine and Chinese patent medicine, Chinese decoction pieces require more manpower. There is no compensation policy for all aspects of loss in Chinese patent medicine. Hospitals are responsible for relevant disposable consumable items. Conclusion The management of Chinese decoction pieces in our hospital is in an awkward situation, which calls for countermeasures as soon as possible.

OBJECTIVE:To provide reference for the optimization of automatic system in outpatient pharmacy of the hospital. METHODS:Based on PDCA(Plan,Do,Check and Action)cycle management,the modules for adding and dispensing drugs of the automatic system in the outpatient pharmacy were optimized and the work records and quality indexes before (July-September in 2013) and after (May-July in 2014) the optimization were compared. RESULTS:By the optimization of the software system, hardware equipment and staff training,the error rate of adding drugs was reduced by 95%,daily box number of added drugs was increased by 30.9%,monthly box number of drugs damaged by the machine was decreased by 80%,the error rate of dropping drugs was decreased by 96.6%,and the frequency of machine fault was decreased by 87.5%,compared with before. CONCLU-SIONS:By PDCA cycle management,the work efficiency of automatic outpatient pharmacy can be improved,and the errors of prescription dispensing are reduced.