Objective To compare the clinical effect of simple volar or dorsal plate fixation of intra-articular distal radius fracture.Methods This retrospective study included 42 patients with closed intra-articular distal radius fracture treated surgically using the dorsal or volar plate.Out of the 15 patients in dorsal plating group 5 were males and 10 females at age of (55 ± 7)years (range, 48-62 years), 13 were injured from falls and 2 traffic accidents, 10 were classified as AO type C3 and 5 AO type C2.Out of the 27 patients in volar plating group 8 were males and 19 females at age of (56 ± 6)years (range, 50-62 years), 24 were injured from falls and 3 traffic accidents, 17 were classified as AO type C3 and 10 AO type C2.Between-group differences were compared with respect to wrist range of motion, postoperative radiographic parameters, postoperative complications, disabilities of the ann, shoulder and hand (DASH) score and Gartland-Werley score.Results All the patients were followed up for 11-25 months.There were no significant differences in the wrist range of motion and radiographic parameters between the two groups (P ＞ 0.05).Volar plating group resulted in a significantly better Gartland-Werley score compared to dorsal plating group [1 vs 4 points, P ＜ 0.05], but no significant difference was noted in DASH score (P ＞ 0.05).Four patients (27％) in dorsal plating group developed tendon adhesions and tenolysis was in demand, but one patients (4％) in volar plating group was complicated by median nerve symptoms (P ＜ 0.05).Conclusions Although the DASH score of the two methods was similar, volar plating yields better results in Gartland-Werley score and complication incidence.Thus the volar plating is recommended for intra-articular distal radius fracture.

[Objective]To reconstruct anterior cruciate ligament (ACL) by using ligament advanced reinforcement system(LARS),and to investigate the integration of LARS artificial ligament with bone interface in the animals with regard to imageology, biomechanics and histology.[Method]Twenty-four Boer goats were randomly divided into three groups. The animal mode of ACL reconstruction was established by clinical ACL reconstruction system. Gross observation was made, and histological, imageological and biomechanical changes were observed at 4, 8 and 12 weeks after surgery, respectively. Statistical analysis was performed.[Result](1)At 4 weeks after surgery,ligament-bone interface had great amount of loose bindweb and infiltration of chronic inflammation cells. At 8 weeks after surgery, there was new bone formation. Part of samples had Sharpey fibers. At 12 weeks after surgery, Sharpey fibers.and a large number of fibroblasts were noted in the interface between LARS artificial ligament and bone interface. But calcified cartilage was not founded.(2)The imageology examination for group 3 was made at 4, 8 and 12 weeks after surgery. The data were analyzed statistically by the image processing software of eflime,and there was evident statistical difference (P0.05 ) .[Conclusion]After ACL reconstruction by LARS artificial ligament, indirect connection developed via Sharpey fibers in bone tunnel at the end of LARS artificial ligament and bone interface. The integration of LARS artificial ligament with bone interface has been improved and its intensity is increased.

Objective To investigate the correlation between tumor necrosis factor (TNF)-α,interleukin (IL)-6,platelet activating factor (PAF) with the blood coagulation disorder in severe craniocerebral injury.Methods Collected 65 subjects (observation group) with severe craniocerebral injury from January in 2009 to June in 2012 with the trauma index ≥17 points,glasgow coma scale ≤ 10 points,combined with other parts of the injury and died in the emergency department were excluded.Examined platelet count (PLT),activated partial thromboplastin time (APTT),prothrombin time (PT),D-dimer (D-D),TNF-α,IL-6 and PAF meanwhile were emergency treated,selected the same period 43cases of health as control group,these indicators were compared.Results PLT in observation group was significantly lower than that in control group [(74.91 ± 30.70) × 109/L vs.(191.52 ± 23.31) × 109/L] (P ＜0.01),APTT,PT in observation group was significantly longer than that in control group [(69.44 ± 15.52) s vs.(22.47 ± 9.41) s,(30.37 ± 8.22) s vs.(9.57 ±4.53) s] (P ＜0.01),D-D,TNF-α,IL-6,PAF in observation group was significantly higher than that in control group[(1 934.92 ± 708.49) U/L vs.(105.78 ± 44.53) U/L,(39.93 ± 18.88) μg/L vs.(1.28 ±0.59) μg/L,(417.61 ±73.66) μg/L vs.(63.93 ±41.49) μ g/L,(16 359.91 ±4 321.92) ng/L vs.(3 823.45 ±529.72) ng/L](P＜0.01).PLT in observation group was negatively correlated with TNF-α,IL-6 and PAF (r =-0.929 2,-0.944 5,-0.932 4,P ＜ 0.01),APTT was positively correlated with TNF-α,IL-6 and PAF (r =0.910 2,0.932 7,0.978 6,P ＜0.01),PT was positively correlated with TNF-α,IL-6 and PAF (r =0.934 1,0.955 4,0.978 6,P ＜ 0.01),D-D was positively correlated with TNF-α,IL-6 and PAF (r =0.942 1,0.943 8,0.941 8,P ＜ 0.01).Conclusions TNF-α,IL-6 and PAF all participate in the process of the blood coagulation disorder in severe craniocerebral injury.The inchoate interference and treatment such as lessening stress responses and inflammation responses against TNF-α,IL-6,PAF is possible to improve the blood coagulation disorder in severe craniocerebral injury and to decrease the death rate of patients.

Objective To investigate the effects of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)on acute myocardial functional lesion after severe craniocerebral injury.Methods Sixty five examples with severe craniocerebral injury are collected in the 253th hospital of PLA from February in 2009 to May in 2012,of whom glasgow coma scale was low or equal to 8 points.They are examined creatine kinase-MB(CK-MB),cardiac troponin T(cTnT),TNF-αand IL-6 for correlative analysis while they are emer-gency treated at the same time.Results The myocardial function of the observe group examined results:CK-MB(198.63±37.72) U/L,cTnT(548.17±49.58)pg/mL;injury factors examined results:TNF-α(39.93± 18.88)ng/mL,IL-6(469.61 ±73.66)ng/mL.It both has evidently difference between the control group and the observe group and has obviously correlation between the my-ocardial function and injury factors of the observe group (P <0.01),and they were positively correlated.Compared TNF-α,IL-6 in observe group,CK-MB(r>0.911 4)and cTnT(r>0.942 1)had statistically significant difference.Conclusion TNF-αand IL-6 all participate in the process of the acute myocardial functional lesion after severe craniocerebral injury.The inchoate interference and treatment against TNF-αand IL-6 are possible to have inhibited the high expression of TNF-αand IL-6 in the blood and to improve the myocardial functional lesion after severe craniocerebral injury.

This paper explored factors influencing initiatives of clinical teachers in millitary medical university for training clinical undergraduates including work pressure after being transferring to civilian,work pressure,policy orientation,economic pressure,student factor and psychological factor,etc. Meanwhile,this paper explored the incentive mechanism of clinical teachers in millitary medical university for training clinical undergraduates including training and evaluating clinical teach-ing teachers, innovating evaluation criterion and creating sustainable teaching atmosphere (building examples and establishing various incentive systems). All measures taken above was mean to inspire the initiatives of clinical teaching teachers and to ensure the quality of clinical teaching.

Drugs, Chinese Herbal ; therapeutic use ; Gastroesophageal Reflux ; diagnosis ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

Objective · To explore the effects of brisk walking on blood pressure, body mass index (BMI), and autonomic nerve activity of male elderly with hypertension in community-based health centers in Shanghai. Methods · A total of 630 elderly men received brisk walking treatment (>10000 steps/d) voluntarily, who were selected from six community-based health centers in Pudong New Area of Shanghai. Among them, 210 people stick to training for 12 weeks. According to whether suffering from hypertension, the people were assigned to hypertension intervened group (intervention group, n=110) and normal intervened group (control group 1, n=100). Blood pressure, BMI, heart rate and autonomic nerve activity before and after the training were compared. Results · After 12 weeks of training, systolic blood pressure (SBP), diastolic blood pressure (DBP) and sympathetic nerve activity of intervention group were significantly lower than those before the training (P<0.05). SBP was also significantly lower than control group 2 (P<0.05). However, heart rate, BMI, parasympathetic nerve activity and baroreceptor reflex sensitivity did not change significantly after the training (P>0.05). Conclusion · Brisk walking treatment lasting for 12 weeks can decrease blood pressure and sympathetic nerve activity in elderly men with hypertension. It is worthy to be popularized in the community.

Objective To evaluate regenerative nerve and functional recovery of target muscle in rats with sciatic nerve defect bridged by acellular nerve allograft made through chemical extraction.Methods Sciatic nerve of SD rats was processed in a volume fraction of 3％ Triton X-lO0 solution and 40 g/L sodium deoxycholate solution.Morphology of myelin sheath,axons and basal lamina tubes of sciatic nerve segments was observed under the light microscopy before and after the chemical processing.Twenty-five Wistar rats were divided into acellular nerve allograft group (n =10),autograft group (n =10) and normal control group(n =5) according to the random number table.A 1 cm sciatic nerve defect was created in acellular nerve allograft group and autograft group,and was respectively bridged by acellular nerve allograft and autograft.Sciatic nerve function index (SFI) was measured every two weeks.Twelve weeks after surgery,nerve conduction velocity (NCV),recovery rate of compound muscle action potential (CMAP) and recovery rate of muscle force were measured in each group.Results Cellular components including myelin sheath and axons were removed thoroughly,but the basal lamina tubes were preserved completely.At postoperative 2,4,6,8,10 and 12 weeks,SFI in normal control group (-1.7±5.9,-0.3 ±2.5,0.8 ±4.1,-1.4±3.6,-2.5 ±5.7 and-2.1±3.2) was superior over autograft group (-94.3±3.7,-90.1±4.1,-63.7±7.8,-51.9±8.2,-48.8±8.6 and -44.3 ± 10.5) and acellular nerve allograft group (-97.1 ± 5.3,-91.2 ± 6.1,-70.6 ± 5.5,-60.4±6.2,-58.2 ±10.2 and-56.4 ±8.0) (P ＜0.01).At postoperative 6,8,10 and 12 weeks,SFI in autograft group were better than those in acellular nerve allograft group (P ＜0.05).NCV [(61.6 ± 8.1) m/s],recovery rate of CMAP[(98.7 ± 5.9) ％] and recovery rate of muscle force [(101.8 ± 6.6) ％] in normal control group were higher than those in acellular nerve allograft group [(22.3 ± 4.7) m/s,(40.3 ± 9.2) ％ and (43.8 ± 9.3) ％] and those in autograft group [(29.0 ±5.5) m/s,(52.5 ± 10.6) ％ and (54.3 ± 10.5) ％] (P ＜ 0.01).NCV,recovery rate of CMAP and recovery rate of muscle force in autograft group were better than those in acellular nerve allograft group (P ＜ 0.05).Conclusions Acellular nerve segments are harvested satisfactorily by chemical extraction.Sciatic nerve defect in rats can be cured with the acellular nerve allograft,but the repair effect of autograft is relatively better.

ObjectiveTo study the role of chemokines and their receptors in peripheral blood in the pathogenesis of breast cancer in elderly patients.MethodsSerum levels of regulated on activation normal T-cell expressed and secreted(RANTES),macrophage inflammatory protein-3 α (MIP-3α ) and stromal cell derived factor-1(SDF-1) were determined by double-antibody sandwich enzyme-linked immunosorbent assay(ELISA) in 30 elderly patients with breast cancer(breast cancer group) and 30 normal controls (control group).Meanwhile,chemokine receptors,CC chemokine receptor(CCR)5,CCR6 and CXC chemokine receptor(CXCR) 4 on peripheral blood CD3+ T-cell in two groups were analyzed by flow cytometry.ResultsSerum levels of RANTES,MIP-3 α and SDF-1 in breast cancer group were significantly higher than those in control group [ (27.9 ± 16.6) μ g/L vs.( 12.6 ± 4.2) μ g/L,( 10.9 ± 7.1 ) μ g/L vs.(5.4 ± 3.5 )μg/L,(339.4 ±94.6) ng/L vs. (195.0 ±70.8) ng/L,P ＜0.01].There was no significant difference in expressions of CCR5,CCR6 and CXCR4 on peripheral blood CD3+ T-cell between two groups(P ＞ 0.05).ConclusionThe abnormal increase of serum levels of RANTES,MIP-3 α and SDF-1 in peripheral blood may play role in the carcinogenesis and progress of breast cancer in elderly patients.

Objective To evaluate the gastroesophageal reflux symptom in patients who underwent continuous ambulatory peritoneal dialysis (CAPD) and the efficacy of proton pump inhibitor (PPI) in treating gastroesophageal reflux. Methods Fifty-eight CAPD patients with good clinical and complete dialyzed eondition,who was admitted to the hospital between Jan. 2008 and July 2008, were inquired about their gastroesophageal reflux symptoms using reflux disease questionnaire (RDQ). The patients who had RDQ≥6 and <12 were received esomeprazole 20 mg daily, while those with RDQ≥12 were received esomeparzole 20 mg twice daily. RDQ score was reevaluated 4 weeks after treatment.Results The common symptom was regurgitation (64.70%), followed by acid reflux (52.9 %), non-cardic chest pain (47.1. %) and heart burn (17. 6%). After 4-week treatment, the RDQ was significantly decreased (P< 0. 05). But there was no difference in outcome of treatment between patients with RDQ≥ 12 and RDQ< 12 (P=0. 059). Conclusion The gastroesophageal reflux symptom in CAPD patients can be relieved by PPI administration, but a larger clinical trial is needed to evaluate the course and efficacy of treatment.