[Objective]To summarize efficiency evaluation of treatment for tibial plateau fracture,to select optimal treatment for tibial plateau fracture in clinical practice.[Method]Retrospective analysis of 138 patients of tibial plateau fracture in our hospital from January 1999 to January 2003.They were all fresh fracture within 2 weeks after trauma,79 cases male 59 cases female,age 15~76,average 43.5 yrs.95 cases complicated with ligament and meniscus injure in knee joint.according to B 1,B2 were treat with manipulative reduction,traction AO classification and sinking degree,they were divided into type B and type C.type and external fixation of splint.Type B3,C1 were treated with prize-up replacement,grafting and internal fixation with screws.Type C2,C3 were treated with firm internal plate fixation.[Result]133 cases were followed up for 6~36months in 138 cases of tibial plateau fracture,average 23 months.Recovery of knee function were divided according to KDLMERI classification.Type B1B2B3 excellent rate 100%.C1 excellent 14cases,fair 2 cases.C2 excellent 10 cases,fair 8 cases.C3 excellent 6cases,fair 3 cases,badly 2 cases.Recovery of knee fruction excellent 118 cases(88.7%),fair and spoor 15cases(11.3%).[Conclusion]sinking degree of articular surface must be emphasized in treatment oftibial plateau fracture.Satisfied therapy effect can be obtained with early function exercise of knee joint.

Gastrointestinal tumor patients are characterized by malnutrition resulting from various elements. So it is necessary to analyze,assess, and treat malnutrition of patients with gastrointestinal tumor. Nutrition support is an indispensable step in tumor therapy.

Objective To investigate CT and MRI findings of giant cell tumors of the temporal bone(GCTTB).Methods CT and MRI features of 5 cases pathologically proven GCTTB were retrospectively reviewed.The lesion characteristics,including location, size,shape,margin,attenuation on CT scans,signal intensity on MR images,and enhancement pattern were documented and analyzed.Results In all 5 patients,the lesions were located adj acent to the mandibular fossa.These lesions were round or oval in shape,predominantly demonstrated as expansive lytic bone destruction containing hyperattenuating septa,calcifications,non-sclerotic borders,and discontinuous bony shells,with“boundary angle”sign.No soft tissue masses were found around the lesions.These lesions with different content demonstrated various MRI signal intensity,and the solid component enhanced intensely.Conclusion GCTTB is rare.Features such as expansive growing pattern,discontinuous bony shell,intralesional septa,calcification,and “boundary angle”sign are common,which may help in the radiographic diagnosis of giant cell tumor.

Presented in the paper are the Patient Clinical Complexity Level(PCCL)and Episode Clinical Complexity(ECC)models as used in Australia.Comparison of the differences between ECC model and PCCL model,and a replacement of ECC model of PCCL model in measurement of disease complexity,points the way for localized scheme design in China.

Objective The change of thyroid hormones affects male sexual function, but the underlying physiological mechanism is not yet clear.The aim of this study was to explore the association of thyroid hormones with abnormal penile neuro-electrophysiology in patients with premature ejaculation (PE).Methods This retrospective study included 52 acquired PE (APE) patients aged 35.36 ± 8.39 years and 24 healthy males aged 32.87±7.45 years.We measured the levels of thyroid hormones in all the subjects and, based on the latency time of penile sympathetic skin responses (PSSR), classified the APE patients into a normal (n=31) and an abnormal PSSR type (n=31).Results The concentration of total tetraiodothyronine (TT4) in the serum was significantly higher in the APE patients than in the normal control ([102.81±18.37] vs [92.68±11.56] nmol/L, P=0.018).The levels of serum TT4 and free tetraiodothyronine (FT4) were both markedly increased in the APE patients of the abnormal PSSR type as compared with those of the normal PSSR type ([113.28±20.89] vs [95.72±12.42] nmol/L, P<0.001 and [12.02±0.88] vs [10.81±1.63] nmol/L, P=0.003).The FT4 concentration was correlated negatively with the latency time of PSSR (r=-0.363, P=0.008) and positively with the Premature Ejaculation Diagnostic Tool (PEDT) scores (r=0.455, P=0.001).Conclusion Abnormal PSSR may be associated with elevated levels of thyroid hormones in APE patients, and regulation of thyroid hormone levels may help improve the symptoms of PE with abnormal PSSR.

Objective To analyze the status of healthcare-associated infection(HAI)and characteristics of patho-gens in patients with traumatic brain inj ury and cerebrovascular diseases,and evaluate prevention and control meas-ures.Methods Clinical data of 236 patients with traumatic brain injury and cerebrovascular diseases in a hospital from 2008 to 2010 were analyzed retrospectively.Results A total of 29 patients developed 50 times of HAI,HAI rate was 12.29%,HAI case rate was 21.19%,HAI case rate of respiratory system,urinary system,oral cavity, gastrointestinal tract,skin and soft tissue,and other sites was 46.00%(n=23),30.00%(n=15),8.00%(n=4), 6.00%(n=3),4.00%(n=2),and 6.00%(n=3)respectively.A total of 69 pathogenic strains were detected,per-centage of gram-negative bacteria was 65.22%(n=45),the major were Pseudomonasaeruginosa(n=17),Klebsiel-lapneumoniae(n=12),Escherichiacoli(n=10),and Acinetobacterbaumannii(n=4);percentage of gram-positive bacteria was 30.43%(n=21),the major were Staphylococcusaureus(n=11),Staphylococcusepidermidis (n=7), Streptococcus spp.(n=2);percentage of fungi was 4.35%(n=3).Conclusion HAI in patients with traumatic brain inj ury and cerebrovascular diseases is high,the main infection site is respiratory system,the main pathogens are gram-negative bacteria.Preventive and control measures should be taken accordingly.

Objective:For developing the study of MUC1/Y vaccine,constructed th eukaryotic expression vectors expressing MUC1/Y.Used it to modify the DC inducint CTL in order to treat the gastrointestinal cancers.Methods:Obtained the MCU1/Y cDNA full length cloned it into pIRES2 EGFP that expressing green fluorescence protein and pcDAN3 1+ respectively.Selected 8 cases of gastrointestinal cancer whose HLA phenotype was A2,inducing DC using rhIL 4 combined with GM CSF in vitro.Transfected DC with pcDAN3.1 MUC1/Y then co cultured DC with T cell to induce CTL (named as T pcDAN3 1 MUC1/Y).At the same time,used pIRES2 EGFP MUC1/Y to detect transfection efficiency.SW620 (HLA A2+,MUC1/Y+),the gastric cancer cell line was used as specific target cell;Lovo(HLA A2 ,MUC1/Y+)and Raji(HLA A2 ,MUC1/Y )were used as unspecific target cells.The cytolytic of specific CTL was measured by LDH releasing assay.The apoptosis of target cells were detected by ANNEXIN V FITC kit.The ability of IFN ? releasing of T cells was measured by ELISA.Results:The transfection efficiency of plasmid was about 8%.There was significant difference between the cytolytic activity of T pcDNA3 1 MUC1/Y to SW620,Lovo and Raji.The cytolytic activity was about (42 8?6 15),(27 26?1 96)% and (22 73?2 15)% respectively.Compared with T IL 2)CTL induced by PBMC stimulated of IL 2(100 U/ml)) and T pcDNA3 1(CTL induced by DC transfected by pcDNA3 1+),the cytolytic activity of T pcDNA3 1 MUC1/Y against SW620 cell line showed a significant increase.The results of ANNEXIN V-FITC experimences showed that T pcDNA3 1 MUC1/Y could induce apoptosis of specific target cell.Conclusion:The expressing of MUC1/Y mRNA has important sense in gastrointestinal cancer.Constructed eukaryotic vector pIRES2 EGFP MUC1/Y that contains full length MUC1/Y cDNA could be used to study the transfection efficiency and select the positive clone;pcDAN3 1 MYC1/Y could induce powerful CTL immunoresponse.

Background Rosuvastatin has been unanimously recognized as an very highly efficacious statin. Rosuvastatin significantly reduced microalbuminuria and its powerful anti-inflammatory effect confer anti-atherosclerosis in patients with essential hypertension. Objective To study the influence of rosuvastatin on microalbuminuria and arteriosclerosis plaque of carotid and coronary arteries in hypertensive patients. Methods Seventy-six hypertensive patients were randomly to receive conventional anti-hypertensive drugs (amlodipine 5 mg/d and telmisartan 80 mg/d,n=37) or rosuvastatin (10 mg QN) on the top of conventional anti-hypertensive drugs (n=39). The blood pressure,levels of microalbuminuria,echocardiography and helical computerized tomography were examined before and 8 months after treatment in all patients. Results After 8 months of treatment,SBP and DBP were decreased in both group [conventional treatment from (166.3?11.2)/(92.4?8.2) to (133.6?9.8)/(85.5?6.1)mmHg,combined group from (165.6?10.5)/(91.5?6.7) to (128.1?9.2)/(81.1?5.9)mmHg]. Combined treatment significantly reduced the levels of microalbuminuria [(31.6?21.8) to (23.2?19.8)mg/g,P

abnormality from cardiomyopathy and endocardial fibroelastosis. Some pediatric patients have overlapped characteristics of both infant and adult type.

Objective To investigate the value in the diagnosis of tumor of the stomach by hypotonic water filling method com-bined with CT multi planar reconstruction (MPR).Methods CT image data of 21 5 cases with gastric tumor confirmed by operation and pathology in our hospital were analysed retrospectively.Conventional CT enhanced scan was obtained in patients with the stom-ach hypotonic water filling condition,and MPR CT characteristics of lesions were observed.Results In the 21 5 cases of gastric be-nign or malignant lesions,MPR showed 5 pathological types in 210 cases.In the conventional CT examination,the tumor diagnosis rate had obvious improvement in different gastric parts and types of the stomach tumors through CT MPR.Conclusion There is high detection rate in the diagnosis of gastric tumors using hypotonic water filling method with MPR,which can accurately display invasion and metastasis,and reduce the misdiagnosis and missed diagnosis in gastric tumor.