Objective To compare the clinical effect of two ways of the closed reduction internal fixation and open reduction internal fixation in the treatment of joint injury.Methods According to the digital table,84 patients with joint injury were randomly divided into control group and treatment group,42 cases in each group.The control group was given closed reduction and internal fixation,and the treatment group was given open reduction and internal fixation.Results The total time of operation,postoperative hospitalization time,postoperative joint function recovery time of the treatment group were (78.51 ±10.20)min,(13.35 ±2.46)d,(88.43 ±5.27)d,those of the control group were (118.73 ±25.71)min,(19.72 ±3.57)d,(107.42 ±10.33)d,the differences were statistically signifi-cant(t =9.424,9.522,10.613;P =0.000,0.000,0.000).The excellent and good rate of the treatment group was 90.48%,which was higher than 71.43% of the control group,the difference was statistically significant(χ2 =4.941, P =0.026).The treatment group had 1 case of adverse reaction,the control group had 8 cases of adverse reaction, there was statistically significant difference between the two groups(χ2 =6.098,P =0.014).After treatment,the VAS pain score in the treatment group was (2.11 ±0.68)points,which was lower than (4.98 ±1.35)points in the control group,the difference was statistically significant(t =12.305,P =0.000).Conclusion The application effect of closed reduction and internal fixation for patients with joint injury disease is very obvious.

OBJECTIVE: Intraocular lens are applied in trigeminal operations of cataract extraction and comeal transplantation, and the selection of artificial lens is modified. This paper evaluated the application of colodzed polymethyl methacrylate (PMMA) intraocular lens in interlaced non-phacoemulsification cataract extraction with intraocular lens implantation and keratoplasty (trigeminal operation).METHODS: A computer-based online search of CNKI (200312007) and Medline database (1974/2004) was performed for related articles with the key words "colorized intraocular lens, corneal transplantation, cataract, combination operation" in Chinese and "PMMA intraocular lens, cataract extraction, corneal transplantation" in English. Articles related to PMMA intraocular lens in cataract and corneal transplantation trigeminal operation was selected. Meta analysis and repetitive articles were excluded. A total of 11 articles were included and summarized.RESULTS: A total of 21 cases (21 eyes) of corneal leukoma and cataract caused by various trauma or ophthalmopathy underwent colorized PMMA intraocular lens implantation. During the follow-up for 10 months, visual acuities of naked eyes in 92% cases were significantly improved. Two weeks after operations, visual acuities of 9 cases (42.9%) were over 4.7, 10 cases over 4.5, and 2 cases (9.5%) over 4.0. At days 7 to 14 after operation, corneal grafts of 21 cases were completely transparent; 10 months after operation, corneal grafts of 16 cases were completely transparent, 3 cases were semitransparent, and 2 cases were turbid, who underwent second penetrable corneal transplantation.CONCLUSION: The application of colodzed PMMA intraocular lens in penetrable corneal transplantation combined cataract extraction can cure the refracting media turbidity of forepart eye. Compared with traditional operations, trigeminal operation reduces complications, increases safety and improves visual acuity.

Objective To evaluate the effect of irbesartan and nifedipine controlled-release tablets on morning blood pressure surge in patients with essential hypertension. Methods Ninety patients with essential hypertension were randomly divided into irbesartan group ( group A, n = 45) and nifedipine group (group B, n =45). Irbesartan tablets 150 mg/d and nifedipine controlled-release tablets 30 mg/d were respectively given in group A and group B for 4 weeks. The levels of diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure ( MAP ) and morning blood pressure surge ( MBPS ) before and after treatment were measured by ambulatory blood pressure monitoring. Results The DBP, SBP, MAP and MBPS levels of two groups after treatment for 4 weeks were all decreased (P < 0.01). All the indexes of group B decreased more significant compared to group A (P < 0.05 ). Conclusion To control blood pressure and prevent morning blood pressure surge, nifedipine controlled-release tablets are better than irbesartan.

Objective To investigate the protective effects of ulinastatin on the lungs in patients undergoing lung resection after chemotherapy for lung cancer.Methods Thirty ASA Ⅱ or Ⅲ patients with lung cancer(Ⅲ a)aged 54-71yr weighing 55-74 kg undergoing lung resection after chemotherapy were randomly divided into 2 groups(n=15 each):Ⅰ ulinastatin group received ulinastatin 10 000 U?kg~(-1) after induction of anesthesia and Ⅱ control group received normal saline instead of ulinastatin.The patients were premeditated with intramuscular pothidine 70 mg and scopolamine 0.3 mg or atropine 0.5 mg.Anesthesia was induced with midazolam 0.05 mg?kg~(-1),fentanyl 4 ?g?kg~(-1) propofol 0.5-1.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with 1%-2% isoflurane inhalation and vecuronium infusion at 0.06-0.08 mg?kg~(-1)?h~(-1).Blood samples were taken after induction of anesthesia(T_1,baseline),at 40 and 90 rain of one-lung ventilation(T_2,T_3) for determination of serum IL-6,IL-8,IL-10 and TNF-? concentrations.Lung specimen was taken from the operated lung at 90 min of one-lung ventilation for microscopic examination with light and electron microscopo.Results Serum IL-6,IL-8,IL-10 and TNF-? concentrations were all significantly increased during one-lung ventilation as compared to the baseline values at T_1 in both groups.Serum IL-6,IL-8 and TNF-? concentrations were significantly lower while Serum IL-10 concentration was significantly higher in ulinastatin group than in control group during one-lung ventilation(P＜0.05).The histopathologic changes of lung tissue were significantly less in group utinastatin than in group control.Conclusion Ulinastatin can effectively protect the lung in patients with lung cancer after chemotherapy by reducing systemic inflammatory response.

Objective To study the probability safety assessment to analyze and evaluate radiation error risk in the external beam radiotherapy,so as to establish and strengthen the control and management of the radiotherapy process,continuous improvement of quality control and quality management.Methods To build the whole of radiotherapy flow chart and process tree,using the decision tree model to determine critical control points in the whole process,making risk assessment chart and analyzing 4 patients with potential safety hazards error.Results The whole process is divided into 22 missions in 3 functional areas,the entire cover 15 branches and 59 key and 11 key control point.The enumeration of error as risks and critical control points has certain correlation.Conclusions Probabilistic safety assessment method have strengthened manage,analyze and control to risk,and all these provide the basis for developing and improving radiotherapy process control management.Radiotherapy quality management for future multidisciplinary and high-level management personnel who take up provides a prospective study.

Objective To investigate the feasibility and safety of helix hydro-jet lithotrity in treatment of calculus of intrahepatic duct and to establish its basic parameters.Methods The parameter of hydro-jet Was set at different levels of pressure(5000-9000 kPa)and different nozzle directions,and the effect of different parameter wag observed and analyzed in three groups.including 32 ex vivo intrahapatic gallstones.thirty-two ex vivo swine bile ducts and 31 ex vivo bile ducts obtained from patients with hepatolithiasis.Results Lithotrity was successful in all groups with a jet pressure of 5000-9000 kPa.The multiple regression analysis showed that the time of procedure depended linearly on the minimal stone diameter,stone weight andjet pressure.The time of procedure and the time needed to damage the bile duct decreased with the increase in jet pressure.At same jet pressure,the smaller the angle between nozzle and bile duct,the longer the time needed to cause damage in bile duct.The technique was successfully performed in 60 patients,with no severe complications,including bile duct injury.Conclusion It is feasible to treat hepatolithiasis with hydro-jet lithotrity.The most optimal operation condition was hydro-jet pressure of 6000-7500 kPa and frequency of 1 Hz.

Objective To explore the Influence of different health education approaches to standard anticoagulation of non-valvular atrial fibrillation. Methods 400 patients with NVAF were randomly divided into the research group (n=200) and the control group (n=200). Baseline clinical information was recorded. Both groups were given regular education and treatment. The control group was randomly divided into two subgroups. One subgroup (patients or/and family members) was given knowledge lectures of atrial fibrillation, atrial fibrillation anticoagulant, and application of warfarin. The other was given the knowledge through booklets. Standard anticoagulation fulfillment rate, ischemic stroke, other events of artery embolism, major bleeding, minor bleeding and death in the two groups were observed after 1 year. The cost for different education approaches was also compared between the 2 subgroups. Results (1)In the research group, standard anticoagulation fullfillment rate (40.53%) was higher than that of the control group(15.96%) (P<0.01). The rate of ischemic stroke (2.63%) was also lower than the control group (4.49%) (χ2=4.49, P<0.05). The death rate was lower in the research group than those in the control group, but minor bleeding rate was higher, without statistically significance (P>0.05).Other artery embolism rate , major bleeding, minor bleeding, death rate had no statistical difference. (2)Knowledge lecture group (10.8±1.0 min) spend more time than the booklet group (1.0±0.5 min) (P<0.01). The booklet group (5.1±1.1 yuan) costed more in terms of money than the knowledge lecture group (1.8±0.5 yuan) (P<0.01). (3)The knowledge lecture group showed higher standard anticoagulation fulfillment rate (47.96%) than that of booklet group (32.60%) (χ2=7.33, P<0.01). There was no statistical difference in ischemic stroke rate, other artery embolism rate, major bleeding rate, minor bleeding rate and the death rate. Conclusions Detailed, correct anticoagulant education and guidance can improve NVAF patients with standard anticoagulation, and reduce the risk of ischemic stroke. Knowledge lecture consumes more time but can improve the standard anticoagulation fulfillment rate.

Objective To investigate the feasibility, safety and short-term efficacy of endoscopic implantation of 5-FU Slow-release Particles for advanced gastroenteric tumor. Methods During the endoscopy procedure,slow-releasing 5-FU agents were implanted densely into the tumors and infiltrated area. Forty-five to sixty pieces of agents ( each piece equivalent to 1.67 mg 5-FU)were injected, which containing an average dose of 100 mg 5-FU. Results A total of 13 advanced gastric cancer patients were enrolled into this study. Significant effects were observed in 3 patients and good effects in 8 patients, but 2 cases with no effects. The total effective rate was 84.62%. The endoscopy examination showed that the size of tumors reduced in various degree at 1 - 2months after the implantation. No hemorrhage or perforation was observed. Parameters of hepatorenal function and routine blood test were stable after implantation. Conclusion Endoscopic implantation of 5-FU Slow-release Particles can relieve the symptoms of patients and limit tumor growth in advanced gastroenteric tumor with no marrow and hepatorenal functional impair.

Objective:To study the diagnostic and therapeutic value of open food challenge in children with cow ′s milk protein allergy.Methods:It is a retrospective analysis of 55 children with suspected cow′s milk protein allergy ( CMPA ) who attended the clinic of the pediatric gastroenterology department ,the First Hospital of Jilin University from March 2014 to March 2015.These children were fed by a mino acid based formulae ( AAF) for 2-4 weeks and then open food challenge ( OFC) test was performed.Those children who tested positive , were diagnosed as having CMPA.They were then fed with AAF for further 3 months and OFC was performed again.Then discusse the diagnostic and therapeutic value of open food challenge in children with cow ′s milk protein allergy.Results:Out of 55 CMPA suspected children ,52 tested positive with OFC yielding a positive rate of 94.55%.These 52 children were fed with AAF for further 3 months and then tested with OFC ,9 children tested positive yielding a positive rate of 17.30%.These 9 children were again fed with AAF for 3 months and then tested with OFC.This time 2 children tested positive yielding a positive rate of 3.85%.Con-clusion:Open food challenge teats are of great significance in the diagnosis of CMPA ,and evaluation of tolerance to cow′s milk protein ( CMP).

Objective To investigate the correlation of serum periostin and severe degree of dilated cardiomyopathy(DCM) in children.Methods Thirty-two children with DCM from Jan.2009 to Jun.2013 in First Hospital Affiliated to Jilin University were selected as DCM group.Then these children were divided into 0-2 score group (n =6),3-6 score group (n =7),7-9 score group (n =11),and 10-12 score group (n =8) according to Ross standardization.Twenty healthy children in the same period were selected as control group.Meanwhile,the levels of serum periostin were detected by using enzyme-linked immunosorbent assay,the levels of serum creatine kinase-MB(CK-MB)were detected by adopting immunosuppressive method,while left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were observed by using uhrasonography.The data in various groups were compared and the relationship between serum periostin and ROSS,LVEF was analyzed by performing linear regression analysis.Results 1.Compared with control group,the level of serum periostin in DCM group was significantly increased,and the difference was significant (P =0.00).The serum periostin level increased with the increase of ROSS score increase,and there were significant differences among the different ROSS score groups (all P ＜ 0.05).2.Compared with control group,the level of serum CK-MB in DCM group was significantly increased,the difference was significant (P =0.00) ;while the serum CK-MB levels had no significant difference among the different ROSS score groups(all P＞0.05).3.Compared with control group,the level of LVEF in DCM group was significantly decreased,the differences was significantly(P =0.00) ; and the LVEF level decreased with the ROSS score increase,there were significant differences among the different ROSS score groups(all P ＜ 0.05).4.Compared with control group,the level of LVEDD in DCM group was significantly enlarged,and the difference was significant(P =0.00) ; but the LVEDD had no significant differences among the different ROSS score groups (all P ＞ 0.05).5.Significantly positive correlation was found between the level of serum periostin and ROSS score (r =0.742,P ＜ 0.001).There was no obvious correlation between the level of serum periostin and CK-MB(r =0.247,P ＞ 0.05).There was negative correlation between the level of serum periostin and LVEF (r =-0.424,P ＜ 0.01).Conclusions The level of serum periostin is positively correlated with ROSS score and has negative correlation with LVEF.It may provide a useful index in the assessment of symptomatic state in children with dilated cardiomyopathy.