Objective To investigate simple manual humeroulnar distraction for alleviating elbow stiffness due to upper limb fracture. Methods Twenty-seven patients with elbow stiffness due to upper limb fracture were divided into control and experimental groups. Before treatment there was no significant difference in stiffness between the groups. The controls were treated with the combined mobilizations and passive stretching. The experimental group was treated with manual humeroulnar distraction alone. Both groups were treated for four weeks. Range of motion ( ROM) and the Mayo elbow function scale (MEFS) were used to evaluate elbow function before and after 4 weeks of treatment. Results After 4 weeks, there was a significant difference between the groups. In the experimental group average ROM reached (110±20) °,an average of 29.6°better than the controls (80.4±23.6) °. MEFS scores also showed significant differences between the experimental group (93. 85±7. 95) and the control group (83.93±9. 24). Conclusions Humeroulnar joint distraction might increase ROM and improve the functioning of stiff elbow joints. This finding may help rehabilitation professionals choose more effective manual mobilization techniques for treating elbow stiffness after upper limb fracture.

Objective To study the influence of aging and chemotherapeutic drugs of breast cancer patients on chemotherapy-induced amenorrhea (CIA) and to guide the further selection of drugs for chemotherapy.Methods We prospectively studied the CIA of the premenopausal breast cancer patients and compared the difference in CIA between the patients who were at different aging periods or received different chemotherapeutics. Results 137 patients were followed up.The occurrence rate of CIA and long-term chemotherapy-induced amenorrhea(LCIA)were 73.72%(101/137)and 43.80%(60/137)respectively.The rate of CIA and LCIA was significandy higher in older women(＞40 years)than young women(≤40 years,X2=25.32,18.42,P＜0.05).The recovery rate of CIA in young women was 61.90%(13/21)which was significantly higher than the older women[35.00%(28/80);X2=4.99,P=0.025].The difference in the rate of LCIA was statistically significant between the older women (＞40 years)who received different anthracyclinebased chemotherapy(X2=6.92,P=0.031).Conclusion Age is an important factor for the CIA.Chemotherapy has less influence on the menstruation of younger women(≤40) and most amenorrhea is reversible.For older women,the rate of LCIA is different in patients who receive imported epirubicin,domestic epirubicin or pirarubicin.

The majority of women diagnosed with early-stage breast-cancer have an excellent long-term prognosis, but many still suffer from worsened life quality and infertility caused by chemotherapy-induced amenorrhea(CIA). The risk of CIA varies by patient age, but is not significantly influenced by chemotherapeutic regimens. CIA will improve disease-free survival and overall survival for patients with hormonal receptor positive tumors. For low-risk patients and patients with the intention of maintaining fertility, proper treatments need to be chosen to preserve their reproductive function.

Objective To compare the effect of spinal anesthesia by using 0.75% ropivacaine or 0.5% bupivacaine in a simulated state of rocking naval vessels, in order to choose an optimal anesthetic agent in a rocking naval vessels at sea. Methods Eighty patients undergoing elective surgery of abdomen or lower limb were randomly divided into 4 groups (n=20). Namely, horizontal level with 0.75% ropivacaine control group (R1), horizontal level with 0.5% bupivacaine control group (B1), simulated rocking with 0.75% ropivacaine group (R2), simulated rocking with 0.5% bupivacaine group (B2). The effect of anesthesia, the changes in hemodynamics and the incidence of relevant side-effects were determined and compared among the four groups. Results The anesthetic level (analgesic level) of group B2 was 2.7 segments higher than that in group B1, and the durations for fixed level was longer than group B1 (P

0.05).But it showed significant higher level in moderate and severe PIH patients than the normal ones. (prepartum. 1195?72、1206?96 vs 1102?89, intrapartum, 1256?81、1308?84 vs 1174?86). The concentration of IECa 2+ has positive relationship with MAP in PIH patients. Conclusions The best method to decrease the harmfulness of overload IECa 2+ is to normalize its level by effective measure of decrease the blood pressure.

Objective To evaluate the expression of adhesion molecules CD62,CD63 and abnormal functional status of platelets in women with preeclmpsia and their relation to progression.Methods The expression of surface antigens CD62,CD63 in peripheral blood and functional status of platelets were measured by flow cytometry in 68 women with preeclmpsia,30 non-pregnant normal women and 52 normal pregnancy women as the controls.Results There was no significant difference among defferent stages in normal pregnant women,but the CD62,CD63 positive platelets were (7 41?1 98)%,(12 99?2 37)% and (36 52?8 92)% respectively for mild,moderate and severe preeclmpsia,it double high (P

Objective To explore the relationship between Lp (a)level and age,gender in Nanjing area.Methods 8 442 ser-um specimens from examination individuals were collected in the First Affiliated Hospital of Nanjing Medical University in 2014.Lp (a)was measured by immune turbidimetry method.All the subjects were divided into six groups:15~29,30~44, 45~59,60~69,70~79 and ≥80 years old.SPSS21.0 software was used to carry out statistics.Results The Lp(a)level in female [134±197 mg/L (M±QR,the same below)]was higher than that in male significantly (U =8 355 137,P <0.001). LP (a)levels from people of different sex correlated with the age weakly (r =0.154,P <0.001),and increased with age groups.Lp(a)of six groups in male were 106.5± 151.0,119.0± 170.0,128.0± 179.0,159.0±206.0,145.0±200.0 and 162.0± 190.0 mg/L respectively.The difference was statistically significant between between 1 and 2 groups,2 and 3 groups,3 and 4 groups,theU value were 645 152.5,1 006 572.0,197 595.0 respectively;P all<0.05.The difference was not statistically significant between 4 and 5 groups,5 and 6 groups,3 and 4 groups,theU value were 59 127.0 and 15 959.5 respectively,P >0.05.Lp(a)of six groups in female were 128.0 ± 194.0,128.0 ± 187.0,139.0 ± 207.0,157.0 ± 228.0, 173.5±227.0 and 150.0±201.0 mg/L.The difference was statistically significant between 2 and 3 groups,theU value was 641 147,P =0.006,respectively.The difference was not statistically significant between 1 and 2 groups,3 and 4 groups,4 and 5 groups,5 and 6 groups,theU value were 783 676,92 442.5,16 069.5 and 3 038,respectively;P all>0.05.Conclusion Lp (a)level in healthy population in Nanjing area is related to gender and age groups,it is necessary to establish different reference ranges.

Objective To compare the effect of establishment of Coronary angiography model in minipigs with right femoral Judkins catheter and 5F universal catheter .Methods Ninteen minipigs were randomized into two groups with right femoral Judkins catheter (ten minipigs)and 5F universal catheter(nine minipigs). Success rate,operation time,X-ray irradiation time were observed .Results The success rate, operation time ,X-ray irradiation time after Coronary angiography in right femoral Judkins catheter group was 100%,(5.68 ±3.53 ) min,(20.84 ±2.45 ) min,in 5F universal catheter group was 88.8%,(6.98 ± 4.13 )min,(26.23 ±8.45 )min.This difference was signifficant( P <0.01).Conclusion Coronary an-giography in minipigs with right femoral Judkins catheter has the advantage of high success rate , less opera-tion time, X-ray irradiation time , is more suit to coronay anatomy of the minipig .

Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disease due to glucocorticoid biosynthesis enzyme deficiency,in addition to the common types such as 21-hydroxylase,11 β-hydroxylase deficiency,also include rare types such as 3 β-hydroxysteroid dehydrogenase deficiency,17α-hydroxylase deficiency and congenital lipoid adrenal hyperplasia (CLAH).These rare types of CAH have multiple clinical manifestations,which are easily missed or misdiagnosed.This article focus on molecular genetics,pathophysiology,clinical manifestations and treatment principles of above 3 rare types of CAH.

MicroRNAs (miRNAs) are small endogenous non-coding RNA molecules.They regulate negatively the expression of target genes at post-transcriptional stages by means of affecting the stability of target mRNA or interfering with the transcriptional process.Recently,there is evidence demonstrating that miRNAs play important roles in the gene expressions of thyrotoxic heart diseases.Elevated levels of thyroid hormones profoundly influence the cardiovascular system through the renin-angiotensin system (RAS).As a principal active component of RAS,angiotensin Ⅱ receptor 1 (AT1 R) interacts with miRNAs in promoting or extenuating the progress of thyrotoxic heart disease.In this article,the roles of AT1R-associated miRNAs,miR-21,miR-155,miR-208a/b,and miR-499 in thyrotoxic heart disease were reviewed.