Objective To compare the clinical efficacy of intramedullary pin versus plate fixation for displaced mid-shaft clavicle fractures.Methods The databases,PubMed,CENTAL and CBM,were searched according to the standards of the Cochrane Collaboration for all the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing intramedullary pin with plate fixation for treatment of displaced mid-shaft clavicle fractures.In addition,hand search was also conducted in relevant journals.Time limit for search was from the beginning till December 2013.Trial quality was assessed using the modified Jadad scale and effective data were pooled for Meta analysis with software RevMan5.2.7,including wound infection,hospital stay,wound size,intraoperative blood loss,operation duration,implant irritation,implant problems,delayed union,malunion,nonunion,total complications and Constant scoring.Results Three RCTs and 7 CCTs with 697 patients were included in our study.The modified Jadad scoring showed fine quality of the 10 trials.Intramedullary fixation was significantly superior to plate fixation in wound size,intraoperative blood loss,operation duration,hospital stay,wound infection,and symptomatic hardware (P ＜ 0.05),but led to a significantly higher rate of implant problems (P ＜ 0.05).However,no significant differences were identified in total complication rate,delayed union,nonunion,malunion or Constant score (P ＞ 0.05).Conclusions The superiority of intramedullary fixation for displaced mid-shaft clavicle fracture lies in its advantages of minimally invasion,such as limited incision,less intraoperative bleeding,shorter operation time and hospital stay,less wound infection and implant irritation.Ahhough intramedullary fixation may lead to a higher rate of implant problems,it shows no significant differences from plate fixation in bone healing and functional recovery.

Objective To investigate the MR imaging (MRI) appearances of postoperative residual liver after hepatic resection for hepatocellular carcinoma (HCC) and the MRI features of tumor recurrences.Methods Twenty patients with previous surgical resection of HCC underwent MR examination of upper abdomen for routine follow-up study or due to clinical suspicion of tumor recurrence. MRI protocol included T1W axial unenhanced images and Gadolinium-enhanced sequences, Gadolinium-enhanced VIBE sequence, unenhanced T2W axial images and coronal TrueFisp sequence.Results Thirteen patients showed normal edge of surgical resection, while 6 patients demonstrated MR signs of incision edge recurrence of HCC and 1 patient was suspicious of tumor recurrence at the incision edge. Among the 20 patients, 12 had MRI features of tumor recurrence of the residual liver, including invasion of left, right and common hepatic ducts 3 cases. Three patients had metastatic lymphadenopathy in portal hepatis, portacaval space and retroperitoneal space. Two patients showed extensive tumor implantation of peritoneum and mesentery. Conclusion MRI is effective in differentiating normal surgical incision edge of residual liver from tumor recurrence. It is also very useful for the early detection of intra-hepatic and extra-hepatic tumor lesions.

The hydrogen peroxide low temperature plasma sterilization technology solved the problems of thermo-sensitive materials' disinfection and sterilization based on its development and unique characteristics. This paper introduced the researches of clinical application quality control, and showed the hydrogen peroxide low temperature plasma sterilizers were being widely used in hospitals and highly recognized. According to the clinical data and the literatures of the domestic equipment in preliminary application, it could be concluded that the technology maturity of domestic hydrogen peroxide low temperature plasma sterilizers was in a high level. The advantages of using domestic hydrogen peroxide low temperature plasma sterilizers to do disinfection and sterilization included lower cost, safer, faster and non-toxic, etc. Also the management system should be improved and the clinical staff should master the technical essentials, obey the procedures strictly, verify periodically and offer full monitoring to upgrade the quality of sterilization.
Cold Temperature ; Disinfection ; instrumentation ; Hydrogen Peroxide ; chemistry ; Plasma Gases ; chemistry

Objective To evaluate the effectiveness of TCM combined with western medicine for advanced gastric cancer.Methods We retrieved literatures of randomized controlled clinical trials related (from January 1991 to June 2012) to the use of TCM combined with western medicine treatment for advanced gastric cancer and made meta-analysis including:the effectiveness,Kamofsky scores and publication bias.Results 44 papers (including 3088 AGC patients) were included.Meta analysis suggested a difference between the treatment group and the control group in effectiveness (Z＝ 6.12,P＜ 0.01),and K score (Z＝ 3.31,P＜0.01).The effectiveness of the reatment group and the control group are 97.8％ and 73.4％ respectively.Conclusion The combined treatment resulted in an improved quality of effectiveness and Kamofsky scores.

Objective To quantitatively determine JAK2V617F mutation by fluorescence quantitative polymerase chain reaction (FQ-PCR)and to analyze its diagnostic value in chronic myeloproliferative disorders(CMPD).Methods FQ-PCR was adopted to detect the positive rate and the relative quantification of JAK2V617F gene mutation in the marrow samples of 68 patients with CMPD.Their diagnostic value in CMPD and their relation with the clinical data were analyzed.Results The marrow samples in 68 cases of CMPD were successfully amplified in wild-type and mutant JAK2V617F.The total positive rate of the JAK2V617F gene mutation was 66.2%(45/68).The positive rate was 75.0%(21/28)in the patients with polycythemia vera(PV),60.6%(20/33)in the patients with primary thrombocythemia(ET)and 57.1%(4/7)in patients with idiopathic myelofibrosis respectively.The posi-tive rate of JAK2V617F mutation in the PV patients was significantly higher than that in the patients with ET and IMF.The JAK2V617F relative quantification in the PV patients was positively correlated with the hemoglobin concentration and white blood cell(WBC)count,and which in the ET patients was positively correlated with the platelet count.Conclusion FQ-PCR can quickly and accurately detect JAK2V617F mutation and its mutation ratio,which provides an effective laboratory indicator for the clinical diagnosis of CMPD.Certain relation exists between the JAK2V617F relative quantification and the clinical hematological indexes of the patients.

Toxic effects of L7 lyophilized powder of extracellular active components (L7-LPEAC), extracted from the Algae-lysing bacteria L7, on Chlorella pyrenoidosa were studied according to the changes of effective photosynthesis rate (EPR), the protein content, the chlorophyll a content and the MDA content of algae. The results showed that the growth of alga was promoted at low concentrations of L7-LPEAC (0.80 g/L, 1.25 g/L). The 96 h-EC50 and 120 h-EC50 upon Chlorella pyrenoidosa are 5.75 g/L and 2.55 g/L, respec tively. The chlorophyll a content increased firstly and then decreased at high concentrations of L7-LPEAC (≥2 g/L), so did the protein content. Compared with the control group, there is a significant statistics diff erence (P

Objective To observe the expression and localiz at ion of tumor necrosis factor alpha (TNF-?) of granulation tissue and chole steatoma in chronic otitis media, and explore its relationship with chronic otit is media. Methods The expression of TNF-? was observe d by immunohistochemical method in cholesteatoma, granulation tissue and normal external ear canal skin in 42 cases with chronic otitis media. Results The level of TNF-? in the group of the sample s including cholesteatoma and granulation tissue increased significantly (P

0.05).In the treat groups seralbumin and plasma osmotic pressure showed significant difference before and after treatment(P0.05).CONCLUSION: There were some adverse effects in the rhGH treatment for malnutritional COPD patients,but they won't influence the treatment.

Objective To investigate the value of LigaSure vessel sealing system for surgery in gastroenteric cancer. Methods From January to September 2009,44 cases of gastroenteric cancer were operated by using LigaSure vessel sealing system,including 13 cases of gastric cancer, 14 cases of colon cancer, 17 cases of rectum cancer. Laparoscopy was employed in 10 cases. Results All the cases were performed successfully. The operation time was 130-250 min, the blood loss was 50-250 ml, and the number of lymph nodes resected was 4-20. None of the cases had serious complications. Conclusion As an optimal hemostatic tool, LigaSure vessel sealing system is safe and feasible for gastroenteric cancer.

Objective To investigate the efficacy of ambroxol combined with penehyclidine hydrochloride for prevention of pulmonary complications after surgery due to acute abdomen in pediatric patients with upper respiratory tract infection.Methods Fifty pediatric patients with acute abdomen complicated with respiratory infection,of ASA physical status Ⅰ or Ⅱ,aged 6 months-5 yr,were randomly divided into test group (group A) and control group (group B),with 25 cases in each group.Immediately after admission to the operating room,ambroxol 1 mg/kg and penehyclidine hydrochloride 0.02 mg/kg were injected intravenously in group A,and atropine 0.02 mg/kg was given in group B.Extubation time and development of laryngospasm,bronchospasm and hypoxemia were recorded.The patients were followed up for 72 h after surgery and the development of postoperative pulmonary complications was recorded.Results Compared with group B,the incidence of hypoxemia and pulmonary complications was significantly decreased,and extubation time was shortened in group A.Conclusion Ambroxol combined with penehyclidine hydrochloride can prevent pulmonary complications after surgery due to acute abdomen and is helpful for prognosis in pediatric patients with upper respiratory tract infection.