Objective To evaluate the clinical applied effects of tibial shaft fracture with intramedullary interlocking nail and small incision. Methods From November 2004 to October 2005,47 cases of tibial shaft fracture were treated with intramedullary interlocking nail, all the cases were adopted with small incision and intramedullary interlocking nail, and analysed the curative effects Results 47 cases were followed-up ranged 8 ～ 27 months. All cases resumed normal knee function 6 to 12 weeks after operation,without nonunion and malunion. Conclusion Treatment of tibial shaft fracture with intramedullary interlocking nail and small incision had the advantages of little trauma,good stability, high rate of fracture union and rapid functions recovery. It is worthy deserveed to be put into application and populatization in clinics.

Objective To observe the diagnostic value of Omeprazole (Losec) test in gastro-esophageal reflux disease. Methods According to clinical manifestations and results of esophageal 24 h pH monitoring and gastro-esophageal endoscopy, 152 patients with reflux symptoms (123 GERD, 29 non-GERD) were randomly, double-blindly divided into group A (Omeprazole 20 mg/d for 1 week), group B(Omeprazole 40 mg/d for 2 weeks), and group C (placebo at the first week, Omeprazole 40 mg/d at the 2 nd week). Symptom score from heartburn, acid regurgitation, food regurgitation, and substernal pain, was recorded before and after taking Omeprazole or placebo. Results After taking Omeprazole 1 week, the symptom score decreasing from GERD patients of group A, B and C was 5.0?4.8、4.9?4.6、2.3?4.0 respectively, score decreasing 2 was the best critical value for GERD diagnosis. There was no difference between Omeprazole 20 mg/d and 40 mg/d for 1 week, the results showed that Omeprazole test (20 mg/d for 1 week) has the best diagnostic value for GERD, the diagnostic sensitivity was 82.5%, specificity was 40.1%, coincident rate was 76.7%. Conclusion Omeprazole test is reliable for GERD diagnosis.

The paper discusses the application of the informatization teaching mode in the surgical nursing teaching and the impact on the information literacy of five-year higher vocational nursing students by taking 213 five-year higher vocational nursing students of the Wuxi Higher Health Vocational Technology School as research objects.The result shows that the application of the informatization teaching mode in the surgical nursing teaching can help improve the comprehensive quality of nursing students.

Objective To characterize and quantify the CD4 +CD25 + regulatory T (Treg) cell population in peripheral blood of patients with ankylosing spondylitis (AS) and to determine the influence of treatment with tumor necrosis factor (TNF)-a inhibitors on them.Methods Peripheral blood mononuclear cells (PBMC) were isolated from 25 patients with active AS,in which 10 patients were treated with 12 weeks of etanercept,and 21 healthy subjects.CD4+CD25high T cells were analyzed using flow cytometry,and mRNA expression of FOXP3 was determined by real-time polymerase chain reaction (PCR).Proliferation of T cells to PHA was measured by WST-1 assay using depleted CD25+ cells by immunomagnetic sorting.Results There was no significant difference in the percentage of CD4+CD25high cells in peripheral blood between patients with active AS and controls (P＞0.05).However,PBMC from patients with active AS expressed reduced levels of FOXP3 mRNA (P＜0.01) which were inversely correlated with C-reactive protein (CRP)(P＜0.01).CD4+CD25+ cells in peripheral blood of both active AS patients and controls exhibited suppressive capacity on the proliferation of effector T cells in vitro (both P＜0.01).Treatment with etanereept increased significantly CD4+CD25high cells and FOXP3 mRNA expression (both P＜0.01),with negative correlations between these increases and decrease in CRP levels (P＜0.05 and P＜0.01,respectively).Conclusion In AS patients,peripheral FOXP3-expressing CD4 +CD25 + Treg cells are abnormal,and are up-regulated by etanercept treatment.This suggests a possible pathogenesis of AS and a potential mechanism for clinical efficacy of TNF-α inhibitors.

Objective To evaluate the significance of coronary calcification and stenosis in elderly hypertensive patients by 16-row multi-sliced computed tomography (MSCT) and its association with peripheral arterial atherosclerosis and other target organ damages. Methods Sixty-four patients with hypertension (n=50) 76.1?6.5 years and normotensions (n=14) 73.4?6.8 years were enrolled. All patients underwent coronary calcification scan by MSCT and the coronary calcification score(CCS) was calculated as AJ130 and Volume. Fourty-four patients in the hypertensive group were subjected to MSCT enhanced scan for evaluation of coronary stenosis. Intima media thickness (IMT), atherosclerotic and calcified plaques in carotid and femoral arteries and ankle-brachial index (ABI) carotid and femoral arteries were measured by echosonography and echocardiography; Fasting plasma blood glucose, blood lipid series, insulin, HOMA-IR, hsCRP and morning urine albumin were determined. Results (1) Both AJ130 and Volume of left anterior descending artery(LAD), left circumflex artery(LCX) and the total calcification score were higher in the hypertensive group than those in the control group (P

Objective The effectiveness on the enrichment of nuclear red blood cells(NRBC) in umbilical cord blood by polyvinylidene difluoride membrane was investigated with intervention on membrane ionic channels.Methods NRBC was isolated by the isolation solution with a density of 1.067 g/ml.The rates of the cell enrichment using verapamil and furosemide intervention by discontinuous density centrifugation were examined by flow cytometry.The NRBC that past through PVDF membrane with pore size of 5 ?m were checked and quantified by nested-PCR.Results The optimal centrifugation density was 1.067 g/ml.The mean purity of NRBC after centrifugation was 2.54%,yet the purity after intervention increased to 9.36%(3.7-fold increment).The NRBC passing through PVDF membrane was from 0.83% to 6.15%,with enrichment of 7.4 times.When NRBC was 120 cells/ml,the density of the nested PCR products increased by nearly 4 times after intervention(4.48 vs 17.78).Conclusions Verapamil and furosemide could affect the morphology of cells and promote the rate of NRBC enrichment.

Objective To analyze the levels of T helper(Th)17-related cytokines interleukin(IL)-17,IL-22,IL-23 and IL-27 in plasma of patients with systemic lupus erythematosus(SLE).Methods Plasma IL-17,IL-22,IL-23 and IL-27 levels were measured by enzyme-linked immunosorbent assay in 45SLE patients and 32 healthy controls and their associations with each other,disease activity and clinical features were evaluated.Results Plasma levels of IL-17 and IL-23 were significantly higher in SLE patients than in controls[77.8(25.4～487.6)pg/ml vs 36.4(15.7～338.2)pg/ml;14.7(<7.8～247.5) pg/ml vs <7.8(<7.8～81.7)pg/ml.both P<0.01].with no difference between active and inactive disease.In contrast,IL-22 levels were markedly decreased in SLE patients compared with the controls[77.4(<15.6～559.7)pg/ml vs 378.8(21.8～1154.2)pg/ml,P<0.01]and were lower in active disease than in inactive disease(P<0.01).IL-27 levels tended to be higher in SLE patients compared with controls,but the difference was not significant (P>0.05).A strong and positive correlation was found between IL-17 and IL-23 levels(P<0.01)in SLE patients.IL-22 levels were negatively correlated with SLEDAI score,erythrocyte sedimentation rate and antidsDNA antibody titers(all P<0.01),and positively correlated with C3 levels (P<0.05).Each cytokine levels were not related to specific manifestations and treatments.Conclusion Th17 cytokine response in peripheral blood of patients with SLE is abnormal.and IL-17 and IL-22 appear to play different roles in SLE pathophysiology.IL-23/IL-27 imbalance may contribute to the development of Th17-mediated inflammation in SLE.

Objective To explore the influence of expert patient progratmne on self-efficacy and serf-management of patients with permanent colostomy. Methods 46 patients with permanent colostomy were participated in expert patient programme .All patients' self-efficacy and self-management were inves-tigated with questionnaire before and after training. Results The score of serf-efficacy and self-manage-ment was increased after participating in the expert patient programme. Conclusions Taking part in ex-pert patient programme may improve self-efficacy and self-management of patients with permanent colosto-my effectively.

Humans ; Organophosphorus Compounds ; analysis ; pharmacokinetics

Objective To explore the role of protein kinase C(PKC) to regulate the activation of nuclear factor-?B(NF-?B)in T lymphocyte in children with acute idiopathic thrombocytopenic purpura(ITP).Methods Sterility peripheral blood was collected from acute ITP children(n=30)and healthy children(n=30).T lymphocytes were isolated and purified,and divided into 3 groups:control group,PMA group stimulated with PMA,PMA plus H-7 group stimulated with PMA and H-7.The expression of NF-?B and inhibitor protein-?B(I-?B)was detected by immunohistochemical staining and Western blot,respectively.Results The percentage of cells with active NF-?B was significantly higher and the expression level of I-?B was significantly lower in acute ITP PMA group than that in acute ITP control group and normal PMA group,respectively(all P