ObjectiveTo explore the effect of external fixation of damage control operation for treating severe multiple injury patients complicated with open tibia and fibula fractures.MethodsFiftyeight severe multiple injury patients complicated with open tibia and fibula fractures from June 2006 to February 2011 were reviewed.According to the control strategy for tibia and fibula fractures,all patients were divided into two groups:32 patients in observation group were treated with external fixation and 26 patients in control group were treated with calcaneal traction or gypsum external fixation.Wound healing time,fracture healing time,and the incidence rate of acute respiratory distress syndrome (ARDS) and multiorgan dysfunction syndrome (MODS),mortality and wound infection rate within 1 month between two groups were compared.ResultsIn observation group,incidence of ARDS and wound infection rate within 1 month,wound healing time was 6.25％(2/32),31.25％(10/32) and (21.47 ± 6.84) d,respectively,while 24.00％(6/25),64.00％ ( 16/25 ) and (30.26 ± 2.18 ) d in control group,respectively,there were significant differences between two groups(P ＜0.05).The differences of the incidence rate of MODS and mortality within 1 month,fracture healing time of observation group were not statistically significant compared with control group (P ＞ 0.05).ConclusionExternal fixation of damage control operation for treating severe multiple injury patients complicated with open tibia and fibula fractures has the advantages of reducing complication occurrence and improving success rate.

Objective To evaluate the effects and the side effects of three-dimensional conformal radiotherapy on recurrent cervical carcinoma with pelvic wall infiltration. Methods Twenty-one patients with recurrent cervical carcinoma infiltrating the pelvic wall were irradiated by three-dimensional conformal radiotherapy. The regimen was: total dose 30-52Gy,5-8.5Gy/f, 1f/2d. Results The rates of sciatic pain and leg edema relief response were 100 % and 61 % respectively. The CR+PR response rate was 71.4 %. The overall 1-, 2- and 3-year survival rates were 38 %, 14 % and 4 %. Conclusion Three-dimensional conformal radiotherapy is more effective than conventional radiotherapy and chemotherapy for recurrent cervical carcinoma infiltrating the pelvic wall. It doesn't increase the side-effects on the digestive system and the urinary system.

Objective To investigate the curative effect of synchronous radio-chemotherapy in medium-term and advanced cervical carcinoma. Methods 168 cases of medium-term and advanced cervical carcinoma were selected. The treatment group(grout A) included 84 pathologically verified cases of stage Ⅱ～Ⅳ cervical carcinoma. Each patient was given DDP with hydration at the dose of 40 mg/m2 intravenously.The treatment cycle was performed once every week for 3--4 circles. Radiotherapy was given at the same time. 60Co was used for external radiation with a total dose of 50 Gy, 192 Ir afterloading unit was used for brachytherapy at the dose of 7 Gy per week at point A with a total dose of 42 Gy. The control group (group B)included 84 cases of cervical carcinoma at the same stage in the corresponding period who received radiotherapy only.Short-term effect ,2-year survival rate and complications were observed. Results Effective rate was 92.85 %(78/84) in group A and 79.76 %(67/84) in group B respectively 3 months after radiotherapy, showing a significant difference(χ2 =6.10,P <0.05). 2-year survival rate was higher in group A (83.95 %) than in Group B(60.98 %) (χ2 =9.4,P<0.05). Local recurrent and distant metastasis were lower in Group A than Group B. In group A, there were tolerable bone marrow inhibition and reaction of digestive tract. Conclusion Synchronous radiotherapy and chemotherapy can remarkably improve the survival rate of medium-term and advanced cervical carcinoma. The application of DDP is effective and safe,and its side effect can be accepted by patients, but the long-term effect needs further observation.

Objective The aim of the present study was to monitor the plasma levels of atrial natriuretic peptide(ANP) in patients accepting minimally invasive ablation.Methods The demographic and clinical data were collected from 26 consecutive patients with paroxysmal atrial fibrillation.Two milliliter of peripheral blood was harvested before operation,7 days and 3 months post-operation followed by ANP assay using ELISA kit.The repeated measurements were performed for each sample and One-way ANOVA was used for statistical analysis.Results Before operation,the ANP levels in plasma was (2.86 ± 1.47) pg/ml.No significant changes of this ANP levels were observed 7 days and 3 months after operation,which were(2.83 ± 1.08) pg/ml and(2.75 ±0.87) pg/ml,respectively.The Pvalue of sphericity Mauchly test was 0.008 for repeated measurements and for correction coefficient,P =0.801.Conclusion These findings suggest that the minimally invasive ablation and left appendage excision in patients with atrial fibrillation has no significant effect on atrial ANP secretion.

0.05),but the level of P- selectin in treatment group were obviously decreased compared with control group after the seventh and fourteenth day(P

Objective To investigate apoptosis of HepG2 ceils after transfecfion with LIGHT gene and interferon-γ. Methods LIGHT gene and interferon-γ were transfected into HepG2 cells by liposome mediated method. The HepG2 cells were divided into group A (transfected with LIGHT gene or interferon-γ), group B (transfeeted with LIGHT gene and interferon-γ) and group C (non-transfection group). The apoptosis rate of the HepG2 cells and the expression of Bcl-2 and Caspase-8 were detected 12, 24, 48 hours after transfeetion. Results (1) The apoptosis rates of HepG2 cells at hour 12, 24 and 48 after transfeetion were 18.8% ± 3.5%, 25.7%± 2.8% and 36.4% ±3.6% in group A, 23.8% ±2.4%, 31.1% ±2.1% and42.5% ±4.5% in group B, and 8.7% ± 2.1%, 9.3% ± 1.6% and 10.9% ± 1.2% in group C. There was a significant difference in apoptosis rate among the 3 groups (F = 15.69, 53.33, 48.28, P < 0.01). (2) The expression of Bcl-2 in HepG2 cells at hour 12, 24 and 48 after transfection was 16.4% ± 5.0%, 13.4% ± 3.5% and 8.6% ± 2.3% in group A, 14.7%±3.8%, 9.1% ±2.0% and 4.6% ±2.0% in group B, and 25.3% ±6. 3%, 19.8% ±4.4% and 10.1% ±3.8% in group C. There was a significant difference in the expression of Bcl-2 among the 3 groups (F = 6.19, 12.29, 5.81, P <0.05). (3) The expression of Caspase-8 at hour 12, 24 and48 after transfection were 19.3% ±2.4%, 27.2% ±1.9% and 33.7% ±3.0% in group A, 22.7% ±2.2%, 30.9% ±3.1% and 38.2% ±3.2% in group B, and 1.2% ±0.8%, 1.8% ±0.6% and 3.2% ±1.5% in group C. There was a significant difference in the expression of Caspase-8 among the 3 groups (F =71.54, 112. 78, I01.61, P < 0.01). Condusions LIGHT gene can signiticanfly promote cell apoptosis through regulating the expression of Bcl-2 and Caspase-8. Interferon-γ enhanced the effect of LIGHT gene on the apoptosis of HepG2 cells.

Objective To study effect of parecoxib on sufentanil dosage and its analgesic effect in patients with laparoscopic radical resection of rectal carcinoma under combined anesthesia.Methods 120 cases patients diagnosed with rectal cancer and prepared to laparoscopic radical resection of rectal cancer were selected in Kailuan General Hospital, and randomly divided into experimental group and control group, 60 cases in each group, experimental group induced anesthesia with 40mg parecoxib sodium intravenous injection, while the control group were treated with normal saline, the postoperative dosage of sufentanil, analgesia pump using frequency and other indicators were detected at 6,12,24 and 48 h, and analgesic effect were observed.Results Compared with control group, in experimental group, postoperative dosage of sufentanil was less ( P <0.05 ) , analgesia pump pressing times and effective pressing numbers were fewer (P<0.05), VAS pain score was lower (P<0.05) and Ramsay score was lower (P<0.05) at each time point.Conclusion Parecoxib could reduce the dosage of sufentanil after laparoscopic radical resection of rectal cancer, and enhance the analgesic effect.

Objective To explore the role and relationship of N-terminal pro-brain natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9 ) in risk stratification and prognosis assessment of non-ST elevation acute coronary syndrome (NSTE-ACS).Methods We recruited 114 patients with NSTE-ACS and classified them into three groups according to the GRACE risk stratification:high-risk,intermediate-risk and low-risk groups.Another 5 8 patients were recruited as controls.Arterial blood was collected before angiography for the measurement of serum NT-proBNP and MMP-9 .Gensini score was used to evaluate the degree of coronary artery stenosis.All the patients were followed up for 6 months and MACE was observed and recorded.Results ① The levels of lg NT-proBNP and MMP-9 significantly differed between the groups (P<0.05).② ROC curve analysis showed that lg NT-proBNP could predict MACE of NSTE-ACS;area under the curve was 0.795,the cutoff value was 2 .0 6 9 ,corresponding to the NT-proBNP value of 1 1 6 .5 6 ng/L.MMP-9 could predict MACE of NSTE-ACS;area under the curve was 0 .6 9 6 ,the cutoff value was 3 2 .4 9 ng/ml;both of the abnormal indexes could predict MACE with the sensitivity of 80.41%,specificity of 82.19%,and Youden’s index of 0.63.③ Cox regression analysis showed that abnormal MMP-9 and NT-proBNP levels were independently related to the incidence of MACE by the value of OR as 3.751.Conclusion MMP-9 and NT-proBNP may be used as serological indicators in risk stratification of NSTE-ACS. The combined use of NT-proBNP and MMP-9 increases the power of predicting MACE.

ObjectiveTo evaluate the relationship between the proliferation of parathyroid cell in rabbit with primary hyperparathyroidism (PHPT) and the bone mineral density (BMD). MethodsEighty adult Chinese rabbits were randomly and equally divided into two groups. The contrast group was fed with normal diet ( Ca ∶ P, 1.0 ∶ 0. 7 ) and the experimental group was fed with high phosphate diet ( Ca ∶ P,1.0∶7.0) to establish the animal model of PHPT. At 3, 4, 5, and 6 months after the diet, bone mineral density of the rabbits was measured by the quantity CT (QCT). Then, the parathyroid and bone of the rabbits were removed for pathological examination. The number of parathyroid cell in PHPT was calculated.Proliferation was determined by immunohistochemistry of proliferation cell nuclear antigen ( PCNA ) and Bcl-2. The t test and Logistic regression was used to analyze the difference of data of two groups. ResultThe number of parathyroid cell in PHPT group was 1.61 times than that in the contrast group[ (673 ± 151 ) HP,(418 ± 25 ) HP,P ＜0. 01]. The rate of PCNA positive-cell was significantly increased in PHPT group than that in contrast group [(50.52 ± 11.62)％o, (26.70 ± 2. 78 )％, P ＜ 0.01], and so was Bcl-2[ (460. 37 ± 190. 05 )‰, (67. 02 ±:4. 38 )％‰,P ＜0. 05]. The value of BMD was significantly decreased in PHPT group than that in contrast group [ ( 152. 5 ± 34. 3 ), ( 188.6 ± 12. 2 ) g/cm3, P ＜ 0. 05]. There was a negative correlation between BMD and PCNA (r ＝ -0. 749, P ＜ 0. 05 ) and between BMD and Bcl-2 (r ＝-0.800, P ＜ 0. 05 ) in PHPT group. ConclusionThe BMD of PHPT is related to the parathyroid cells proliferation which provide a reliable method for early diagnosis of PHPT.

Objective To explore the relationship between abnormal copy number of mitochondrial DNA (mtDNA) and prognosis of the patients in colorectal cancer (CRC).Methods A total of 60 cases of CRC and corresponding adjacent noncancerous tissue specimens were selected.Genomic DNA was extracted.The mitochondrial ND1 gene was detected by quantitative real-time polymerase chain reaction and β-actin was set as internal control.And then the copy number of mtDNA was caculated and analyzed by t-test.The prognosis of patients was determined by Kaplan-Meier survival analysis.Results The mean mtDNA copy number of CRC tissue was 108.60±20.11,while that of the corresponding adjacent noncancerous tissues was 153.68±25.72,the former was significantly lower than that of the latter (t=10.69,P＜0.01).The rate of low mtDNA copy number in case with positive lymph nodes metastasis was higher than that in cases with negative lymph nodes metastasis (x2 =4.022,P＜0.05),however there were no obvious correlation with gender,age,pathological type,TNM stage.The survival rate of high mtDNA copy number group was higher than that of low mtDNA copy number group,however there was no statistical significance (P＞ 0.05).Conclusions mtDNA copy number of CRC was significantly lower than that of the adjacent noncancerous tissues.However the change of copy number was not correlated to the prognosis.