Owing to the advanced age,limb hemiplegia,dehydration,and vessel wall injury,stroke may be easy to cause venous thromboembolism (VTE).VTE mainly include deep vein thrombosis (DVT) and pulmonary embolism (PE).DVT refers to abnormal blood clotting in the veins and impedes venous return.The dislodgement of emboli from the vessel wall can form a thrombotic embolism,and cause PE,myocardial infarction,and stroke; it can not only prolong hospitalization,but also increase the mortality.This article reviews the incidence,risk factors,treatment,and prevention of DVT after a stroke.

Objective To compare the clinical results of minimally invasive percutancous plate os-teosynthesis (MIPPO) and open reduction with internal fixation (ORIF) for treatment of distal tibial fractures. Methods From October 2006 to June 2007, 94 cases of closed distal tibial fracture with intact articular surface were treated by internal fixation with plates. Of them, 42 were treated with ORIF and 52 with MIPPO. We retrospectively analyzed their union time, malunion and complications. Results The average follow-up was 14.5 (8 to 24) months. In the ORIF group, 35 cases got union, 3 cases delayed union and 4 cases nonunion. The average time for union was 3.83 (3 to 8) months. There were no cases of malunion and 2 cases of superficial infection in this group. In the MIPPO group, 47 cases obtained union, 5 cases delayed union and none nonunion. The average time for union was 3.66(2 to 8) months. No significant differences were found between the 2 groups in total union time or in the union time for Type AI, Type A2 and Type B fractures respectively. The union time for Type A3 fracture was longer in the MIPPO group than in the ORIF group, but the union time for Type C fracture in the MIPPO group was shorter than in the ORIF group. In the MIPPO group, external rotation occurred in 2 cases and posterior angnlation displacement in 3, and 8 cases com-plained of discomfort around the ankle which was relieved after removal of the plate. Conclusions Gen-erally speaking, there is no significant difference between ORIF and MIPPO in union time for distal tibial fractures. ORIF may be superior to MIPPO in treatment of Type A3 fracture, but inferior to MIPPO in treatment of Type C fracture. A high rate of delayed union may be expected in patients who have been treated with MIPPO and have had anteroposterior angnlation.

Objective To summarize the clinical experience of coronary angiography before coronary artery grafting (CABG) with concomitant valvular surgery in patients with valvlar disease. Methods From April 2000 to May 2005, two hundred and eleven patients over 50 years old (mean age 60 3.5) with valvlar diseases were studied retrospectively. Coronary angiography was utilized for patients who were found to have risk factors for atherosclerosis. Coronary stenosis over 50% of its calibre was considered positive, and 75% stenosis (including LMCA stenosis more than 50%) was used as the indication for coronary artery bypass surgery. Results Coronary angiography was employed in 128 patients and 30 cases (23.4%) had coronary artery stenosis exceeding 50%. CABG was concomitantly performed during cardiac valvular surgery in 24 patients. In-hospital mortality in patients with valve surgery alone was 0.5%, which was significantly lower compared with patients with valve surgery combined with CABG group (4.2%)(P

ObjectiveTo investigate the roles of apoptosis and express io n of PCNA in human vulnerable atherosclerotic plaque.MethodsAp optosis was detected by TUNEL.Expessions of PCNA were detected in samples of vul nerable plagues From 23 cases of coronary heart disease.by SP immunohistochemica l technique.ResultsThe expession level of PCNA in the smooth m uscle cells (SMCs) on fibrous cap region was significantly elevated than that of the other three regions.The expession level of PCNA in the inflammatory cells ( ICs) on fibrous cap and shoulder region were significantly elevated than that of the other two regions.The amount of apoptosis in the SMCs on lipid-rich core wa s much more than that of the other three regions.The amount of apoptosis in the ICs on lipid-rich core was more than the other three regions.The expression leve ls of PCNA in fibrous cap and shoulder were significantly higher than TUNEL posi tive cell (P

Objective To investigate the relationship between carotid intima-media thickness (IMT) and coronary atherosclerosis plaque through coronary CT angiography (CTA) in asymptomatic individuals.Methods Two hundred and fifty cases with CTA screened were selected in asymptomatic individuals,and according to the inspection result they were divided into no plaque group (detection of no coronary atherosclerosis plaque,180 cases) and plaque group (detection of coronary atherosclerosis plaque,70 cases).All cases were checked carotid IMT with B-ultrasonic.Results ANOVAs analysis showed that age and body mass index (BMI) had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).x2 test was used to show the smoking and family history of coronary heart disease had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Univariate Logistic regression analysis showed that carotid IMT,systolic pressure,diastolic pressure,low density lipoprotein cholesterol,fasting serum glucose and creatinine had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Multifactor Logistic regression analysis showed that carotid IMT had correlation with coronary atherosclerosis plaque (P ＜ 0.05).Conclusion There is significant relationship between carotid IMT and coronary atherosclerosis plaque in asymptomatic individuals.

Objective To investigate the characteristics of attention networks impairment in patients with lesion in the cerebellum.Methods The attention network test was used to compare patients with lesion in the cerebellum(n=28)with normal controls(n=3.1)on the efficiency of three anatomically defined attention networks:alerting,orienting,and executive control. Results The orienting network effect was significantlyworse(Z=-2.309,P＜0.05)in patients with lesion in the cerebellum((36.32±30.58) ms)than in normal controls((54.39±22.17)ms).The executive control network in patients((160.05± 83.25)ms)with lesion in the cerebellinn was worse than those of controls((93.42±37.41)ms,Z= -3.500,P＜0.01).The alerting networks effects was higher in patients((35.14±45.59)ms)than in normal controls((28.81±26.09)ms),without significant difference.The average reaction time was longer in patients than in normal controls,but there was no significant difference.The wrong rate of attention network testwas significantly higher(Z=-2.119,P＜0.05)in patients(6.57%±9.84%)than in normal controls(3.38%±5.42%).Conclusion The patients with lesion in the cerebellum may be selectively impaired of the orienting and executive networks,while the alering network is spared.

BACKGROUND:It has been reported that mesenchymal stromal cells(MSCs)are capable of differentiating into cells of multilineage.Different methods and reagents have been used to induce the differentiation of MSCs,but most inducing systems contain serum and cytokines.OBJECTIVE:To investigate the gene expression of mash-1 and ngn-1 in differentiation of SD rat bone marrow-derived mesenchymal stem cells induced by salvia mitiorrhiza. DESIGN:Controlled experiment in vitro with repeated observation and measurement based on cells.SETTING:Department of Anatomy,School of Preclinical and Forensic Medicine,Sichuan University. MATERIALS:This study was performed in the Department of Anatomy,School of Preclinical and Forensic Medicine,Sichuan University from October 2004 to December 2005.SD male rats weighing 160-200 g were purchased from the Animal Center of Sichuan University.The experimental animals were disposed according to ethical criteria.Parenteral solution of salvia mitiorrhiza purchased from Tianyang Medicine Company Limited of Anhui(batch number:20050411).METHODS:The nucleated cells were separated from rat bone marrow through gradient centrifugation and cell adherent method,and then MSCs differentiated into neurcyte-like cells induced by salvia mitiorrhiza.Cells in the control group were cultured with salvia mitiorrhiza-free serum-free culture media.The expression of neuron specific enolase(NSE)and glial fibrillary acidic protein(GFAP)were detected by immunohistochemistry.RT-PCR was used to detect the mRNA of mash-1 and ngn-1. MAIN OUTCOME MEASURES:①mash-1 and ngn-1 expressions were detect by the RT-PCR method.②NSE and GFAP expressions were detected by immunohistochemistry.RESULTS:①The MSCs were well adherent to walls.Most of the cells transformed in dipolar-like or multipolar-like.Axon-like or dentrite-like process was developed and these processes synapse with each other.② RT-PCR showed that ngn-1 and mash-1 mRNA were negative before induction,but positive after induction.③Immunohistochemistry indicated that NSE and GFAP expressions were positive after induction but negative in the control group. CONCLUSION:MSCs can be induced to differentiate into neurocyte-like cells by salvia mitiorrhiza.

Objective To investigate the development of rat heart and the expressions of TGF-?1,SMAD4 and Bax protein to detect the location and mechanism of action in different developmental periods of rat heart. Methods Histology and immunohistochemistry of rat embryonic hearts from day11 to day19(E11～E19) in paraffin-embedded were used to analyze the heart development and TGF-?1,SMAD4 and Bax protein expressions. Results The muscular part of interventricular septum appeared on E12.5,and the partition of the ventricle finished on E16.The positive expression of TGF-?1 can be seen in the rat embryonic heart during E11～E19.The positive staining was increased to E15 and then declined significantly.The expression of SMAD4 was enhanced gradually and the positive signals were strong on E17,and a spatial difference was found in the expression on E13.The expression peaks of the Bax protein appeared on E15 then subsided to a stable.Conclusion The critical period of cardiac muscle cell differentiation and heart moulding was E15.TGF-?1,Smad4 and Bax protein play important roles during the development of rat embryonic heart.

Objective: The study has been testing the efficiency of attention networks in Chinese adults. Methods: The study has used "ANT" to examine 76 normal Chinese adults and analysed the effect on alerting, orienting and executive attention. Results: The reaction time across whole ANT is 502-940(706?105)ms, and the correct ratio is 93%-100%(0.97?0.07).The alerting effect is 30?20ms, orienting effect 51?24ms, and conflict effect 106?32ms. Correlation analyses demonstrate no correlation between alerting, orienting, and conflict resolution. Conclusion: ANT produces reliable subject estimates of alerting, orienting and executive attention function.

Teaching ability is the comprehensive embodiment of expertise and personal cultivation,and it is closely related to teaching results.The teaching ability of teachers in the field of traumatology and orthopedics of TCM is developed in their practice of clinical work and teaching practice,which reflects the efficiency and quality of their classroom teaching and clinical teaching.The elements of teaching ability in the field of traumatology and orthopedics of TCM should be strengthened by approaches such as professionalism,the ability of teaching design,the expertise of modem educational technology and professional dedication.