Objective To evaluate the clinical significance of anatomic reduction and internal fixation of posterior malleolar fracture in ankle fracture surgical treatment. Methods Fifty-four patients with posterior malleolar fracture were treated with anatomic reduction and internal fixation from March 2005 to June 2010. The patients groups consisted of 36 males and 18 females. According to CT scan classification,the group was made up of 36 type Ⅰ cases, 10 type Ⅱ and 8 type Ⅲ cases. All patients were evaluated with modified Baird-Jackson scoring system. The relationship between final result and fracture pattern , fixation methods, the time of exercise initiation fitted operation were analyzed respectively. Results The followedup period varied from 6 months to 36 months, with an average of 18 months. The number of patients whose result was excellent, good, fair and poor was respective 29,18 ,5 and 2. The total percent age of good to excellent clinical result was 87. 03%. There were 4 patients who had only slight pain after long time walking ,the remainder patients were completed with no pain. Conclusion Operative treatment may provide satisfactory fracture anatomic reduction and internal fixation for posterior malleolar fracture. Correct fracture pattern estimation and proper internal fixation are important to achieve and improve reduction quality, and to ameliorate better long term results.

Objective:To clarify the mechanism of immunoregulation of bone marrow stromal cells(BMSCs) transfected interleukin 18(IL-18) after their transplantation into glioma bearing rats.Methods:Cultured BMSCs from SD rats were transfected with rmIL-18(BMSCs/IL-18).Untransfected BMSCs were used as control.Culture supernatant medium was collected for IL-18 examination at different time point by ELISA kit.After establishment of glioma bearing rats followed by BMSCs/IL-18 transplantation,serum concentration of IFN-?,IL-2 and IL-10 were examined by means of ELISA kit.And their splenocytes were cultured with C6 cells and BMSCs/IL-18 for in vitro cytotoxicity assay,and subsets of splenocyte were detected by flow cytometry.TUNEL was used to clarify apoptosis cells inside glioma and anti-CD34 staining was performed to observe microvessel density(MVD).Results:BMSCs/IL-18 could secret IL-18 long term and stably.After being transplanted with BMSCs/IL-18,serum concentration of IL-2,IFN-? in glioma bearing rats' increased obviously and serum concentration of IL-10 decreased.Flow cytometry results showed that CD4+ and CD8+ T lymphocytes increased in the splenocytes.And rechallenge with C6 cells induced a rapid immuno-reaction.In vitro cytotoxicity assays.It was showed that BMSCs/IL-18 could stimulate splenocytes to kill C6 cells obviously.TUNEL assay showed that there were 15.74?6.23 apoptosis cells inside glioma in each view in Group 2,which was much more when compared with other groups.Microvessel density inside glioma in group 2(6.51?2.71) was lower than in group 1(13.52?3.06),group 3(12.67?2.61) and control group(14.84?1.47).Conclusion:By means of inducing Th1 cytokine and suppressing Th2 cytokine and activating cytotoxic T lymphocyte,BMSCs/IL-18 induces obviously anti-tumor activity.

Objective: To observe the effects of autotransplantatio n of costochondral graft in the defects in temporomandibular joint. Methods: Twenty New Zealand white rabbits aged 3 months were div ided into 4 groups: the animals in group A received autotransplantation of 4 mm costochondral graft and in group B received that of 1 mm after excision of the disk, condyle and upper part of the ramus. The rabbits in group C received the same excision operation without graft transplantation as surgical controls and those in group D were used as healthy controls. Samples of temporomandibula r joint were obtained and examined by X-ray cephalometry and histopathology. Results: Cephalometric measurements revealed that height of the mandibles on left side was significantly shorter than that on right sid e in group B and C(P

Using a syngeneic transplantable leukemia model of 615 inbred mice, named L615, we (1) compared the adoptive immunoprophylactic(AIP) effects of spleen cells from various normal dornor mice with different genetic background and from different immune-deficient mice;(2) studied the adoptive immunotherapeutic (AIT) and adoptive chemo-immunotherapeutic(ACIT) effects of immune spleen cells from those survival mice in the AIP groups;(3) analysed the antitumor activities of various murine spleen cells either nonspecifically activated in vitro or specifically induced in vivo and resensitized in vitro by MMC-treated L615 tumor cell vaccine (TCV).Our results might provide some new experimental evidences for clinical application of cancer ACI.

Progressive stroke is a therapeutic challenge for clinical practice. Some factors, such as infection, hypotension, hyperglycaemia and fever were related with progressive stroke. The clinical features, imaging, laboratory examination could predict the development of progressive stroke. Treatment include anticoagulation, reduce fibrinogen，temperature，glucose，enlarge capacity，control brain edema, protective agent and surgery.

OBJECTIVE To investigate the distribution and drug-resistance of extended-spectrum ?-lactamases((ESBLs)) producing Gram-negative bacteria in the hospital,in order to control and treat them.METHODS The bacteria were detected and isolated with VITEK TWO system,the suspected ESBLs producing bacteria were(detected) with K-B method.RESULTS There were 1 889 isolated strains of Enterobacteriaceae and the ESBLs(producing) bacteria were 302 strains including E.coli(551),K.pneumoniae(583),and others bacteria(755).Their(positive) rates bacteria were 18.5%,24.7%,and 7.4%,respectively;the wards isolated rate was in the following order: 38.2% were in surgical ICU,29.9% in medical ICU,20.5% in surgery wards,20.6% in oncology wards,12.7% in respiratory wards.12.4% in hematology wards,10.3% in cadre wards,6.4% in endocrinology wards,and 1.6% were in(others) wards.ESBLs producing bacteria were better sensitive to imipenem and meropenem,then to piperacillin(/tazobactam) and cefoperazone/sulbactam.CONCLUSIONS(Enterobacteriaceae) could be(detected) accurately with VITEK TWO system.The main sources of ESBLs producing bacteria are patients in ICU and chronic(patients).To kill these bacteria,imipenem and meropenem can be used first,then(piperacillin)/tazobactam and(cefoperazone)/sulbactain.

Objective To investigate the relationship of TCM constitution and syndrome elements based on patients with hyperhomocysteinemia. Methods A survey was conducted among 1316 patients with diabetes, coronary disease, hypertension and cerebral infarction. Totally 326 patients with hyperhomocysteinemia were incorporated in diagnostic data and their constitutions were determined. At the same time, syndrome elements identification method for syndrome elements was applied for judgment, and consistency of the constitution and syndrome elements was analyzed. Results The survey showed that prevalence rate of population with hyperhomocysteinemia was 24.77%;there were 6 cases with mild nature, and 320 cases with biased constitution;phlegm dampness, blood stasis, qi deficiency of constitutions 110 cases, 73 cases and 59 cases, respectively;blood stasis, phlegm, qi deficiency, and dampness were the main syndrome elements of hyperhomocysteinemia, of 100 cases, 98 cases, 73 cases and 59 cases, respectively;the consistency of phlegm dampness constitution and syndromes of phlegm was the most obvious (Kappa=0.89, P<0.05). Conclusion Phlegm dampness, blood stasis, and qi deficiency were the most common constitutions of hyperhomocysteinemia;blood stasis, phlegm, qi deficiency and dampness were the main syndrome elements of hyperhomocysteinemia patients. The two results were consistent, and the consistency of phlegm syndrome and phlegm dampness constitution was the most obvious.

Objective To establish the m ethod to analyze γ-hydroxybutyric acid (GHB ) and its precursors 1,4-butanediol (1,4-B D ) and gam m a-butyrolactone (GBL) in urine through LC-M S/M S and provide evi-dence for related cases. Methods GHB-d6 and M O R-d3 were used as the internal standard. The urine sam ple w as separated by LC after protein precipitation w ith m ethanol. The electrospray ion source w as for ionization. E ach com pound w as detected through m ultiple-reaction m onitoring (M R M ) m ode. Results The lim its of detection of GHB and its precursors 1,4-B D and GBLwere 0.1, 0.1 and 2μg/m L. The accuracy w as 87.6% -98.1% . The intra-day and inter-day precisions were less than 15% and m atrix ef-fects were higher than 80% . Conclusion The m ethod is high sensitive, sim ple, rapid, specific and w ith high reliability. This study has provided technical support and basic data for forensic cases involving GHB .

Objective: To study the expression of negative costimulatroy molecule B7-H4 in non-small cell lung cancer (NSCLC) tissues and its relationship with the clinical features of NSCLC. Methods: Fifty-two NSCLC specimens from pa-tients who were pathologically diagnosed in our hospital during January 2008 to April 2009 were included in the present study. B7-H4 expression and infiltration of CD3~+ T cells in NSCLC tissues were detected by immunohistochemistry. The correlation between B7-H4 expression, CD3~+ T infiltration, and the clinical features of NSCLC was studied. Results: The positive rate of B7-H4 in 52 NSCLC tissues was 48.08% (25/52), and B7-H4 expression in normal lung tissues was neg-ative or low (P <0.05). B7-H4 expression was positively correlated with the clinical tumor stages and lymph node metas-tasis of NSCLC (P < 0.05), and negatively correlated with tumor infiltration of CD3~+ T cells (P < 0.05), but had no re-lationship with clinicopathologie parameters of NSCLC (P > 0.05). Conclusion: Negative costimulatroy molecule B7-H4 may play important roles in the development of NSCLC. Positive expression of BT-H4 is correlated with the clinical tumor stages and lymph node metastasis of NSCLC, which provides a foundation for diagnosis and therapy of NSCLC.

ObjectiveTo establish a method for content determination of total iridoid compounds and baldrinal and 11-ethoxyviburtinal from Valerianae Jatamansi Rhizoma et Radix; To determine the contents of total iridoid compounds and baldrinal and 11-ethoxyviburtinal in Valerianae Jatamansi Rhizoma et Radix from three medicinal origins.Methods UV spectrophotometry was applied, 11-ethoxyviburtinal (cyclopentane-pyran-7-formaldehyde, 4-ethoxy methyl) was set as the reference substance, and the content of total iridoid compounds was determined at 288 nm. HPLC method was used to simultaneously determine the contents of baldrinal and 11-ethoxyviburtinal. The HPLC analysis was performed on a Phenomenex Luna C18 column (250 mm×4.6 mm, 5μm). The mobile phase was composed of acetonitrile-water in gradient elution at a flow rate of 0.95 mL/min. The detection wavelength was 288 nm and the column temperature was 30℃.Results The total iridoid compounds, baldrinal and 11-ethoxyviburtinal were in good linearity within the ranges of 2.088–14.616μg/μL, 74.88–224.64μg, and 41.6–249.6μg, respectively. This method was precise, and with good repeatability, stability and recovery rate.Conclusion The method is accurate, simple, rapid, which can be used for the quality control of Valerianae Jatamansi Rhizoma et Radix.