Objective To study the related factors of operating on Pilon bone fracture.Methods 35 cases with tibial Pilon fracture treated operative,according to the Reedi-Allgower were divided the type,Ⅱ type 15 examples,Ⅲ type 20 example.14 cases were treated with open redcution and inter fixation plate and screws and 11 cases were treated with open reduced minimal and exter fixation that cast.Results According to Mazur's grade system treatment was evaluated may in 28 cases,18 cases of which were type Ⅱ racture and 10 cases type Ⅲ fracture poor in 7 cases,2 cases of which were type Ⅱ fracture and 2 cases type Ⅲ fracture.Conclusion The curative effect with fracture type,repla-cement mass and operation time are relative in tibial Pilon fracture.

Objective To investigate the potentiality of specific miRNA level in blood plasma of ovarian cancer patients as a molecular marker to predict sensitivity and response to platinum-based chemotherapy .Methods Quantitative polymerase chain reac-tion ( Q-PCR) was used to check the changing of miRNA level in blood plasma before and after chemotherapy , and explored the rela-tivity between variation and chemotherapy response and clinic outcome .Results Among preliminary screened 11 miRNAs, only 5 miRNAs were able to be detected in peripheral blood .There existed variations in 3 miRNAs ( miR-22, miR-106a, miR-142).Further detection of the changing of miRNA level in blood plasma before and after therapy , miR-22 was found significantly up-regulated in blood plasma that was underwent platinum-based chemotherapy .Meanwhile, ovarian cancer patients with high miR-22 level were most-ly sensitive to platinum-based therapy.Otherwise, miR-22 was positive relative to the clinic prognosis of patients with ovarian cancer . Conclusions miR-22, miR-106a, and miR-142 might participate in the generation and development of ovarian cancer .miR-22 in pe-ripheral blood was probably identified as a novel molecular marker of prediction of the sensitivity to platinum in ovarian cancer patients .

The paper presents a flexible and simple direct analysis in real-time ( DART) device without grid electrode for mass spectrometer injection. It contained inert carrier gas, ionizer, heater and temperature-controller etc. Excluding the grid electrode and then reducing the structure units, the device could be easy to build up in low cost and flexible to connect with a variety of mass spectrometers. The experimental conditions like the kind of carrier gas, flow rate and temperature were investigated for the device. By using argon as carrier gas, flow rate as 7. 5 L/min, and temperature of heat tape as 300 ℃, the device was used to analyze benzene alcohol, linoleic acid, dichlorvos emulsion, mosquito coils, citrus peel, and sample ( propranolol hydrochloride) on thin-layer plate combined with mass spectrometer. The results were accurate and the device was stable and reliable.

@@

Objective To summarize the experience of tension-free repair for inguinal hernia in the preperitoneal space using modified surgical mesh. Methods From Dec 2008 to May 2010, 134 cases with 138 reducible primary inguinal hernia were randomly divided into two groups. Sixty-seven patients (70 hernias) in the study group underwent tension-free repair in the preperitoneal space by modified surgical mesh, while the control group (67 cases, 68 hernias) underwent Rutkow's herniorrhaphy by surgical mesh.Results Postoperatively 127 cases (95%) were followed up from 2 to 18 months with an average of 9. 2months[64 cases of the test group were followed up with an average of(9 ±4) months, 63 cases of the control group followed up with an average of (9 ± 5 ) months]. There was no recurrence. No significant differences were found between the two groups in the operation time (P = 0. 697), blood loss (P = 0. 318 ),hospital stay (P = 0. 116) and total postoperative complications (P = 0. 080). The visual analogue scale of the study group was lower than the scale of the control group ( P = 0. 048 ). Conclusions Modified surgical mesh is more comfortable in the treatment of inguinal hernia with tension-free repair in the preperitoneal space with a comparative result to Rutkow's herniorrhaphy by surgical mesh.

Through to the new reform under the background of hosting the analysis of the hospital management , put forward according to the construction of talent as the breakthrough point , the two-way referral system , focus on building characteristic specialized platform , stick to the quality construction , carrying out medical core system vig-orously and also carrying out fine management , set up the mechanism of medical quality long -term improvement , constantly improving the quality of connotation construction level , lay a foundation for hosting the hospital sustain-able development .

Objective To evaluate the development of extravascular leakage of 6％ hydroxyethyl starch (HES) 130/0.4 when used for acute hemodilution in the pediatric patients undergoing open heart surgery.Methods Forty-eight American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients,aged 2-12 yr,weighing 12-53 kg,scheduled for elective surgical repair of ventricular or atrial septal defect,were divided into 2 groups (n =24 each) according to age:preschool group (2 yr ≤ age ≤ 6 yr) and school-age group (6 yr＜age ≤ 12yr).After anesthesia induction and endotracheal intubation,a volume of 6％ HES 130/0.4 equivalent to 10％ of the blood volume was infused via the central veins at 0.5 ml · kg-1 · min-1 in two groups.Immediately before infusion of HES (T0) and at 15 and 30 min after the end of infusion (T1,2),blood samples were collected fron the central vein for determination of plasma colloid osmotic pressure (COP) and hemnoglobin (Hb) concentrations.The concentrations of 6％ HES 130/ 0.4 in plasma at T1 and T2 and in urine at T2 were measured by the anthranone colorimetric method.Results Compared with the baseline value at T0,the concentrations of Hh in plasma were significantly decreased at T1,2 in preschool group,and the concentrations of Hb in plasma were significantly decreased and plasma COP was increased at T1,2 in school-age group (P＜0.05).There were no significant differences in plasma Hb concentrations or COP at each time point between two groups (P＞0.05).The plasma 6％ HES 130/0.4 concentrations were significantly lower at T2 than at T1 in two groups (P＞0.05).Compared with school-age group,the plasma 6％ HES 130/0.4 concentrations were significantly decreased at T1,2 in preschool group (P＜0.05).There was no significant difference in 6％ HES 130/0.4 concentrations in urine between the two groups (P＞0.05).Conclusion When 6％ HES 130/0.4 is used for acute hemodilution,extravascular leakage happens after acute hemodilution and is more obvious in the preschool pediatric patients undergoing open heart surgery.

Objective:To explore the rational mode of hospital management under the trusteeship mode through the case study of a county-level hospital entrusted by a large general public hospital.Methods:Based on the system construction,the complete sinking of quality medical resources,the cultivation of talents and cultural integration,this paper analyzed the current situation of medical technology and service quality in hospitals before and after trusteeship by a retrospective control study.Results:The medical technology,quality and patient satisfaction of the hospital were improved significantly after trusteeship.Conclusions:The effective measures in the process of trusteeship of county-level hospitals are conducive to improve the level of medical technology and service of county -level hospitals,which can ensure the quality and safety of medical treatment,provide valuable suggestions for decision-making,and promote the development of hierarchical diagnosis and treatment.

【Objective】To compare different approaches and their effectiveness on the treatment of the femoral neck fracture in children,in order to provide a reliable and effective way for the treatment of the disease.【Methods】Clinical data of 21 cases with femoral neck fracture from 1983 to 1993 were analyzed retrospectively.【Results】21 cases were divided into three groups:① group Ⅰ:14 cases underwent closed reduction and internal fixation with multiple Kirscher′s pins or cannulate compression screws under C-arm X-ray monitor.Of the 14 cases,11 cases were healed,3 cases developed ischemic necrosis of femoral head;② group Ⅱ:4 cases was treated with skin traction and hip spica cast plaster fixation,3 cases was healed,1 case developed ischemic necrosis of femoral head;③ group Ⅲ:3 cases underwent opened reduction and internal fixation with multiple pins or cannulate compression screws,1 case was healed,2 cases developed ischemic necrosis of femoral head.【Conclusion】Closed reduction and multiple pins internal fixation under C-arm X-ray monitor may be the best choice of treatment of femoral neck fracture in children.

Objective To investigate the expression of aquaporin (AQP) 1, AQP4, inward rectifying potassium channel 4.1 (Kir4.1) and cytoskeleton features of rat spinal cord astrocytes after cytochalasin D (CytD) intervention. Methods Spinal cord astrocytes isolated from 2~3-day-old rats were cultured till confluency. MTT was used to assess survival rate of astrocytes 2 h, 12 h and 24 h after co-cultured with 0.05 μg/ml, 0.10 μg/ml, 0.20 μg/ml, 0.40 μg/ml, 0.80 μg/ml and 1.00 μg/ml of CytD, respectively. Confocal microscopy was used to observe cytoskeleton features of astrocytes 2 h after co-cultured with 0.05 μg/ml, 0.10 μg/ml, 0.20 μg/ml, 0.40 μg/ml of CytD. The expression of AQP1, AQP4, Kir4.1 mRNA were determined with real-time PCR 2 h after co-cultured with 0.05 μg/ml, 0.10 μg/ml, 0.20 μg/ml, 0.40 μg/ml, 0.80 μg/ml and 1.00 μg/ml of CytD. Results The survival rate of rat spinal cord astrocytes reduced with the time of co-culture and concentration of CytD (P<0.05). The cytoskeleton of astrocytes was reconstructed. The expression of AQP1, AQP4 and Kir4.1 mRNA increased after co- cultured with 0.05~0.40 μg/ml of CytD. Conclusion The appropriate dosage of CytD may remodel the cytoskeleton and increase the mRNA expression of AQP1, AQP4 and Kir4.1 in spinal cord astrocytes of rats.