Objective To explore the clinical application and value of MIPO technique in treating distal tibial fracture.Methods During February 2007 and January 2009,27 patients with distal tibial fractures were treated by MIPO technique using LCP.Based on the AO fracture classification system,7 patients were classified into A2,9 into A3,7 into B2 and 4 into C1.The mean age was 43 years old ranging from 26 to 72 years old.Results The mean follow-up duration was 12 months ( between 4 and 21 months ).According to the Johner-Wruhs score classification system,all the patients were well treated,with excellent efficacy in 19 patients,good in 7 patients and acceptable in 1 patient.No infection or skin putrescence occurred.Conclusion MIPO technique is an ideal measure to treat distal tibial fracture with the advantages such as less incision,higher healing rate,nicer appearance,more stable fixation,less tissue infection,earlier functional exercise and weightbearing activity.

Objective To study the indications of carotid endarterectomy(CEA) and perioperative managements . Methods The clinical data of 11 patients with transient ischemia attack (TIA) and carotid artery stenosis who underwent CEA were reviewed retrospectively. Results After CEA, the TIA symptoms disappeared in all patients, and the chronic symptoms of cerebral ischemia had obvious improvement in 4 cases . There were no serious postoperative complications, such as cerebral hemorrhage, hemiplegia, etc. Conclusions CEA may be considered when one or both sides of carotid stenosis more than 50% is discovered by Duplex scanning, digital subtraction angiography or MRA in patients with TIA. Stage operation for bilateral carotid occlusive lesion is safer. Paying attention to perioperative managements is important for reducing operative complications.

Objective:To evaluate the efficacy and security of two type of rotary nickel titanium system (Twisted File and ProTaper Universal)for root canal preparation based on micro-computed tomography (micro-CT).Methods:Twenty extracted molars (including 62 canals)were divided into two experimen-tal groups and were respectively instrumented using Twisted File rotary nickel titanium system (TF)and ProTaper Universal rotary nickel titanium system (PU)to #25/0.08 following recommended protocol. Time for root canal instrumentation (accumulation of time for every single file)was recorded.The 0-3 mm root surface from apex was observed under an optical stereomicroscope at 25 ×magnification.The presence of crack line was noted.The root canals were scanned with micro-CT before and after root canal preparation.Three-dimensional shape images of canals were reconstructed,calculated and evaluated. The amount of canal central transportation of the two groups was calculated and compared.Results:The shorter preparation time [(0.53 ±0.1 4)min]was observed in TF group,while the preparation time of PU group was (2.06 ±0.39)min (P<0.05).In mid-root level,TF group shaping resulted in less ca-nal center transportation than PU group [(0.070 ±0.056)mm vs.(0.097 ±0.084)mm,P<0.05]. No instrument separation was observed in both the groups.Cracks were not found in both the groups ei-ther based in micro-CT images or observation under an optical stereomicroscope at 25 × magnification. Conclusion:Compared with ProTaper Universal,Twisted File took less time in root canal preparation and exhibited better shaping ability,and less canal transportation.

Objective: To compare the incidences of root cracks after canal instrumentation with HyFlex CM system and the ProTaper Universal system .Methods:Sixty mandibular incisors were mounted in resin blocks with simulated periodontal ligaments , and the apex was exposed .The control group of 20 teeth was not prepared , and the other 40 teeth were divided into 2 experimental groups ( n=20 ) .The 40 root canals of the experimental groups were instrumented using HyFlex CM and ProTaper Universal to the major apical foramen ( AF).The horizontal sections 1 mm, 2 mm, and 3 mm from the apex were observed under an optical stereomicroscope at 25 ×magnification .The presence of cracks was noted . Results:No cracks were found in the control teeth .Cracks were found in 1 of 20 ( 5%) teeth in HyFlex CM group , and 17 of 20 ( 85%) teeth in ProTaper Universal group .The difference between the two experimental groups was statistically significant (P<0.01).Conclusion: The HyFlex CM files caused fewer root cracks than the ProTaper Universal files during the root canal instrumentation .

Objective To determine the hair selenium level by material microwave digestion-atomic fluorescence spectrometry. Methods The selenium in hair was determined by hydride atomic fluorescence spectrometry after microwave digestion, and the method was improved by exploring the test conditions. The linear relationship and linear range of the standard curve, the detection limit, the precision and the accuracy of the sample determination were implemented under the optimized conditions. The selenium value of standard material of human hair was tested by material microwave digestion-atomic fluorescence spectrometry. Results The selenium detection limit of material microwave digestion-atomic fluorescence spectrometry was 0.095 μg/g, the correlation coefficient of standard curve was 0.9997, the relative standard deviation was 1.32% - 2.48%, the average recovery rate was 93.4% - 98.2%, and the selenium value of standard material of human hair was in the standard value range of uncertainty, which met the requirements. Conclusion The method is simple, accurate and precise, and it is an accurate and reliable method for determination of selenium in hair.

Objective To study the nursing of totally endoscopic coronary artery bypass grafting (TECAB)using da Vinci robot.Methods 60 patients who accepted TECAB from January 2007 to December 2010 were selected.All patients underwent coronary arteriography,which showed severe stenosis in left anterior descending artery(LAD).8 of them complicated with right coronary artery stenosis or left circumflex coronary (LCX)stenosis.All patients were given education and nursing care from admission to discharge.Results After operation,angina pectoris alleviated in all cases,no surgery-related complications occurred.The bridge vessel was all cleared.All patients were discharged after rehabilitation.Conclusions Totally robotic TECAB is a new minimally-invasive surgery.Perioperative education is important.In early postoperative course,nurses should pay attention to bleeding condition of drainage and pulmonary nursing.Early postoperative exercise is a must,which can promote the recovery of all systems.

OBJECTIVE:To investigate the effect of liposome formulation in promoting hepatocytes' uptake of tenofovir and cytotoxic effect. METHODS: The tenofovir cationic liposomes were prepared by tert-butyl lyophilization, and its encapsulation efficiency and physico-chemical property were determined. Using human hepatic carcinoma cells SMMC-7721 as a model to investigate the effect of liposome formulation in promoting hepatocytes' uptake of tenofovir. MTT assays were used to examine the toxicity of tenofovir cationic liposomes in different conditions. RESULTS: The prepared tenofovir cationic liposomes had an encapsulation efficiency of (88.3?1.6)%, a size distribution of (278.4?67.6)nm and a Zeta potential of (31?5)mV. The results showed that the liposome formulations containing galactose and PEG modifying lipids resulted in significantly higher and prolonged drug accumulation inside cells as compared with free drugs. The cell survival rates were above 80% when the tenofovir liposome was at a concentration of 7.5?g?mL-1 and lipids at a concentration of 30?g?mL-1, and little toxicity was noted. CONCLUSION: The prepared cationic liposome can greatly enhance hepatocytes' uptake and protection of tenofovir, which is expected to become a highly effective drug delivery system of antiviral drugs such as tenofovir etc.

Objective To explore the effect of Shen-Fu injection(SFI,参附注射液) on expressions of heme oxygenase-1(HO-1) and inducible nitric oxide synthase(iNOS) in renal failure induced by intestinal ischemia-reperfusion injury(IRI) in rats and its possible mechanism in the protection of kidney.Methods The model of intestinal IRI was induced by clamping superior mesenteric artery(SMA) for 1 hour and then releasing the arterial clamp for 6 hours.Thirty-six male Wistar rats were randomly divided into three groups: IRI model group,SFI pretreatment group and sham operation group.In the SFI pretreatment group,10 ml/kg of SFI was pumped in at constant rate 30 minutes before the ischemia,the SMA was clumped for 1 hour and then released,while in the IRI model group,an equal volume of normal saline was pumped in continuously 30 minutes before the ischemia.The serum creatinine(SCr) and blood urea nitrogen(BUN) were observed respectively.Expressions and distributions of HO-1 and iNOS in the rat kidney tissue were detected by immunohistochemitry and morphometry computer image analysis.The histological changes of kidney were observed under light microscope.Results The expressions of HO-1 and iNOS were markedly higher,and the levels of SCr and BUN were also significantly higher in intestinal IRI model group than those in the sham operation group(all P

BACKGROUND: At present, many problems deserve to be solved before clinical utilization of adipose tissue-derived mesenchymal stem cells (ADMSCs) such as complete differentiation from ADMSCs into cardiomyocytes and ADMSCs with or without specific function of cardiomyocytes. It is of significance to solve the problems including how to elevate the differentiation rate of ADMSCs into cardiomyocytes and how to elevate the homing and survival rate after transplantation for clinical utilization of stem cells.OBJECTIVE: To observe the differentiation of ADMSCs into cardiomyocytes after in vitro culture and induction.DESIGN: Randomized controlled observation.SETTING: Laboratory of Cardiology, General Hospital of Chinese PLA.MATERIALS: Adipose tissue was collected from abdominal operative patients at Department of General Surgery of General Hospital of Chinese PLA with the agreement of patients. Iscove's Modified Dulbecco's Medium (IMDM), type Ⅰ collagenase, 5-azacytidine (5-aza) and polyclonal antibody of specific anti-myocardial Troponin T (TnT) were purchased from Hyclon company, Gibco company, Sigma and Fujian Maixin Biotechnology Company, respectively.Monoclone antibodies of CD44, CD45, CD34, HLA2DR and factor-Ⅷ, Desmin, anti-α-striated muscle actin and anti-myosin heavy chain (MHC) were bought from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation. DAB stain, reverse transcription-polymerase chain reaction (RT-PCR) kit and atrial natriuretic peptide (ANP) radioimmunity kit were purchased from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation,Invitrogen and Radioimmunity Research Institute of Science and Technology Development Center of General Hospital of Chinese PLA, respectively.METHODS: The experiment was performed at the Laboratory of Cardiology, General Hospital of Chinese PLA from March 2005 to April 2006. ADMSCs were isolated and cultured by digestion and attachment culture method. The third generation of cells were determined by immunocytochemical method for surface molecule CD44, CD13, CD105, CD45,CD34, HLA-DR, factor Ⅷ and induced by addition of 5-aza into culture medium. On the 7th, 14th, 21st and 28th days, gene of GATA4 and Nkx2.5 were tested by reverse transcription-polymerase chain reaction (RT-PCR), and the concentration of atrial natriuretic polypeptide (ANP) were also examined by radioimmunoassay.MAIN OUTCOME MEASURES: Determination of cell surface marker, gene of GATA4 and Nkx2.5, and ANP concentration.and factor Ⅷ negative for the cultured cells. After induction for 7 days with 5-aza, no cells expressed Desmin,α-Sarcomeric Actin, Myocin heavy chain (MHC) and TnT, most cells were positive stained for CD44. After induction for 14 days, small amounts of cells displayed positive for Desmin,α-Sarcomeric Actin and MHC but still negative for TnT,while partial cells expressed positive CD44. After induction for 21 days, most cells were positive for Desmin,α-Sarcomeric after induction and no significant difference was found compared with that at the 7th day [(0.022±0.01) ng/L (P＞0.05].ANP concentration was respectively (7.92±0.21) and (8.12±0.50) ng/L at the 21st day and the 28th day (P＞0.05), but there was significant difference compared with that at the 7th day (P＜0.05).

Objective To investigate the nursing intervention on the effect of diagnosis and treatment of emergency patients with urolithiasis. Methods 98 patients with urolithiasis in emergency department of our hospital from January 2009 to January 2011 were randomly assigned into the observation group and the control group with 49 cases in each group. The control group received routine care, on this basis the observation group was given systemic nursing intervention. The tolerance, SAS score and satisfaction degree was compared. Results 40 patients in the observation group was well tolerated, accounting for 81.6%, significantly higher than 63.3% of the control group. SAS score and satisfaction degree of the observation group were significantly better than the control group. Conclusions Nursing intervention for emergency patients with urolithiasis can significantly reduce pain, improve the mental state and increase their satisfaction degree, which is worthy of clinical application.