Objective: To investigate the effect of leech injection on thrombosis and plasma tissue plasminogen activator (t PA) and its inhibitor (PAI) in the thrombosis model of mice. Methods: The different dose leech injection of different doses were given to mice in different groups for 7 days respectively. Thrombosis was induced in mice by carrageenan. The plasma t PA and PAI activity were detected by chromogennic substracte analysis.Results: The average thrombosis length of tail in the groups of leech injection were significantly shorter than the length in the groups of thrombosis control. Compared with the group of thrombosis control, the plasma PAI activity in the leech injection groups was lower. Conclusions: The leech injection can reduce thrombosis in mice. The mechanism might be associated with reducing the release of PAI.

Objective To discuss the differences of clinical features and characteristics and features of polysomnography be‐tween elderly patients and middle‐aged patients with obstructive sleep apnea hypopnea syndrome (OSAHS) ,so as to provide refer‐ence for the diagnosis and individualized intervention of elderly OSAHS .Methods Totally 81 aged OSAHS cases and 123 youth OSAHS cases were analyzed in terms of general condition ,clinical manifestations and polysomnographic characteristics ,and the clin‐ical manifestations and polysomnographic difference indicators of the two groups were matched according to body mass index (BMI) .Results Most OSAHS patients were males in both groups ,with BMI and neck waist circumference in the aged group less than those in the middle‐aged group ,and the difference was statistically significant (P<0 .05) ,while the bust was larger than that in the middle‐aged group ,but the difference was not statistically significant (P>0 .05);clinical symptoms of senile groups such as drowsiness ,snoring ,morning headaches ,dry mouth and nighttime awakenings were lower than the middle‐aged group ,the difference was statistically significant (P<0 .05) ,and complications such as hypertension ,diabetes and other risk disease were significantly higher than those in the middle‐aged group ,and the difference was statistically significant (P<0 .05);in the aged group ,the degree of OSAHS was dominated by mild to moderate ,while the middle‐aged group ,was dominated by moderate to severe ,but the differ‐ence was not statistically significant (P>0 .05);REM AHI was more than the middle‐aged group ,the difference was statistically significant (P< 0 .05) ,AHI was less in old age group than in the middle‐aged group ,the difference was statistically significant (P<0 .05);NREMⅠ + Ⅱ stage in the aged group was more than that in the middle‐aged group(P<0 .05) ,and NREM Ⅲ + Ⅳstage ,REM period ,the average SaO2 (% ) ,MAI clear were less than those in the young group;LSAT (% ) was greater than that in the middle‐aged group ,but the difference was not statistically significant (P>0 .05) .Conclusion The incidence of typical clinical manifestations of aged OSAHS patients was lower than that in the middle‐aged group ,but high blood pressure ,diabetes and other complications prevalence were significantly higher than those in the middle‐aged group ,with similar severity of OSAHS in both groups ,there were differences PSG monitoring results with the middle‐aged group ,and the difference of REM AHI was significant .

Objective To observe the therapeutic efficacy of different treatment programs on the acute subjective tinnitus . Methods 327 patients with acute subjectivity tinnitus were randomly divide into physical ,medication and comprehensive treatment group .The 97 cases in physical group were treated with hyperbaric oxygen ,acupuncture and sound therapy ;the 103 cases in medica‐tion group were treated with microcirculation and oral steroids ;the 127 cases in comprehensive treatment groups were treated with combination the therapy of above what have mentioned .THI was used to evaluate three groups before the treatment ,two and four weeks after treatment .Results After two week′s treatment ,the efficiency rate for physical group is 60 .82% ,64 .78% in medica‐tion group and 70 .08% in comprehensive group .After four weeks of treatment ,the efficiency rate of each group is 70 .10% , 72 .81% and 80 .31% .At two‐week time point ,there was no significant difference between drug and physics group (P> 0 .05) , there was statistically significant difference between medication group and comprehensive group (P< 0 .05) .At four‐week time point ,the difference of physics group and drug group had no statistically significance compared with the two‐week in each group (P>0 .05) ,but there was a statistically significant difference in comprehensive group (P<0 .05) ,meanwhile ,there was statistically significant differences between comprehensive group and the physical group and drug group (P<0 .05) .Conclusion Physical and medication therapy have quite effects on acute subjective tinnitus ,but the effect was worse than the comprehensive therapy group . After four weeks of treatment ,the efficiency of purely physical and drug therapy have not been significantly improved compared with two weeks time ,but still improved of comprehensive treatment .

Objective To compare the effects of high negative pressure drainage and conventional drainage on postoperative blood loss and wound healing in patients with calcaneal fracture. Methods A prospective randomized controlled single-blinded trial was conducted on the 66 patients with closed calcaneal facture who had been treated from June 2012 to March 2016 in our hospital. They were randomized by coin into 2 groups: 36 patients (aged from 21 to 65 years with a mean age of 38.1 years) were treated with a high vacuum drainage system while the other 30 (aged from 19 to 66 years with a mean age of 37.5 years) with a conventional silicone tube and a drainage vessel. The 2 groups were treated by the same team of surgeons and the same surgical procedures. The 2 groups were compared in terms of postoperative drainage volume, hemoglobin (HGB), bleeding volume, wound healing time, incision complications and wound infection. Results The high negative pressure group incurred significantly greater drainage volume (516.7 ± 138.8 mL) and bleeding volume (612.9 ± 179.5 mL) than the conventional drainage group (305.8 ± 95.4 mL and 437.8 ± 102.0 mL) (P <0.05). The former incurred significantly less HGB (116.8 ± 6.9 g/L) and wound healing time (15.2 ± 3.1 d) than the latter (124.1 ± 7.8 g/L and 18.5 ± 4.2 d) (P <0.05). The rate of incision complications for the high negative pressure group (5.6%, 2/36) was significantly lower than that for the conventional drainage group (26.7%, 8/30) (χ2=4.150, P=0.042). There was no significant difference between the 2 groups in the rate of wound infection (0 versus 3.3%) (P=0.927). Conclusion After surgery for calcaneal fractures, high negative pressure drainage may lead to faster wound healing and fewer postoperative wound complications but greater blood loss and lower HGB than conventional drainage.

Objective To explore the outcomes of open reduction and internal fixation ( ORIF ) with transarticular screws for Lisfranc injuries and the postoperative incidence of symptomatic tarsometatarsal os-teoarthritis ( OA ) . Methods This retrospective study involved 28 patients who had been treated surgically at our institution between January 2009 and January 2015 for Lisfranc injuries. They were 18 males and 10 females, with an average age of 36. 1 years ( from 19 to 54 years ) . According to the Quenu-Kuss classifica-tion, 5 patients had type-A injury, 10 type-B injury ( 4 cases of type-B1 and 6 ones of type-B2 ) , and 13 type-C injury ( 8 cases of type-C1 and 5 ones of type-C2 ) . The patients underwent ORIF with screws for the 1st to the 3rd tarsometatarsal joints and ORIF with Kirschner wires for the 4th to the 5th tarsometatarsal joints within 2 weeks. After the Kirschner wires were removed 8 to 10 weeks postoperatively, progressive weight-bearing began. Functional outcomes were assessed according to the American Orthopaedic Foot and Ankle Society ( AOFAS ) midfoot scores and visual analog scale ( VAS ) at final follow-ups. Results The mean duration of follow-up was 29. 9 months ( from 26 to 72 months ) . AOFAS scores revealed one excellent case, 22 good ones and 5 poor ones with an excellent to good rate of 82. 1％. The mean VAS score was 2. 8. Radiographic evidence of OA was noted in 20 patients ( 71. 4％, 20/28 ) , in 18 of whom ( 90. 0％) symp-tomatic OA was observed. There was no significant difference ( P=0. 399 ) in the incidence of symptomatic OA either between the patients with anatomic reduction ( 60. 9％, 14/23 ) and those without anatomical re-duction ( 80. 0％, 4/5 ) . Conclusions ORIF with transarticular screws can lead to good therapeutic outcomes for Lisfranc injuries. The incidence of symptomatic OA may not be related to the injury type or re-duction quality.