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.

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 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 explore relationship amongpersonality,family interpersonal dynamics and college students'adaption.Methods:Adaption to college was assessed with the Symptom Checklist 90 (SCL-90)in internet when 1850 freshman selected conveniently from a university in Shanghai (Students with single factor score of SCL-90 equal or greater than 2.5 belonged to the positive group,while the other students with single factor score of SCL-90 all less than 2.5 belonged to the negative group).At the same time,they were evaluated with the Cattell's 16 Personality Factor(16PF)to evaluate their characteristics and Multi-Interpersonal Dynamics Questionnaire for Un-dergraduates (MIDQ-U)for undergraduate students to assess family interpersonal dynamics.Results:The scores of anxiety of 16PFwere higherin the positive groupwith 50 students than in the negative group[(7.2 ±1.4)vs.(4.6 ± 1.9),P <0.001 ],while the scores of extroversion,serenity and alertness of 16PF were lower in the positive groupthan inthe negativegroup.In the SCL-90 positive group,the MIDQ-Uscores of indifference and submissivenesswere higher[(17.3 ±6.0)vs.(14.9 ±4.2),(11.5 ±3.2)vs.(10.3 ±3.1);P <0.001]and the scores of indepen-dencewere lower than that in the positive group[(18.7 ±3.0)vs.(19.8 ±3.4),P =0.02].Path graphanalysiss-howed that anxiety and extroversionpartly predicted freshmen's adaption directly(β=0.57 --0.01 )and partly worked through indifference(β=0.031 --0.004),while decisivenesscompletely functioned through indifference with the coefficient of 0.008.Anxiety had part mediating effect between indifference and freshmen's adaption(β=0.008).In the other three factors,anxietyplayedcompletemediatingrole.Conclusion:Personalities and family inter-personal dynamics may affect each other,then mutually predictstudents'adaption to college.

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.

Objective To determine chest ultrasound locating treatment of paraelectronic effusion by medical thoracoscopy.Methods We chose 40 Xinxiang center hospital patients in respiratory wards from June 2012 to June 2014,who was randomly divided into two teams,one was electron-assisted Thoracoscopic surgery,the other was thoracic cavity closed drainage combination of intrapleural injection of urokinase.It was 3rd reviewed by chest ultrasound,we evaluated curative effection ac cording to the drainage effect,we statisticsed two draining days and total inpatient days,and total hospital costs.The results two teams were compared between gender,age,nutritional status,effusion volume (length x width x depth),pleural effusion conventional,biochemical,lactate dehydrogenase,adenosine deaminase,carcinoembryonic antigen,the difference was not statistically significant (P ＞ 0.05).Pleural fluid culture results were negative.Medical thoracoscopy treatment group hospitalization days,drainage time was significantly shorter than the thoracic drainage combined with pleural urokinase group,The same was the cost of hospitalization.Medical thoracoscopy poor drainage treatment group was significantly lower than the thoracic drainage combined with pleural urokinase group (P ＜ 0.05).Conclusion To the middle-large number encapsulated paraelectronic effusion,chest ultrasound locating treatment by medical thoracoscopy early can reduce the formation of empyema,reduce the formation of pleural fiberboard.It is a safe,effective and worthy of promotion treatment.