BACKGROUND:Treatment of complex tibial plateau fracture is a difficulty in orthopaedic trauma. Comprehensive assessment and appropriate surgical plan before surgery are the key points of surgery.
OBJECTIVE:To investigate the application value of three-dimensional reconstruction and virtual surgical techniques in assessing and surgical planning of complex tibial plateau fracture before surgery.
METHODS:The CT scan data of 30 patients with tibial plateau fracture were imported into the Mimics 13.0 software to establish the three-dimensional digital models of complex tibial plateau fracture, and three-dimensional measurements and reclassification was performed according to three-column classification were made. Virtual surgeries such as bone window operation, reduction of the fracture and bone grafting were made in these models.
RESULTS AND CONCLUSION:Reconstructed three-dimensional digital models of complex tibial plateau fracture could indicate the characteristics of fracture accurately, could be observed at any direction, and could help doctors to reclassify the fracture according to three-column classification. Virtual surgeries of bone window operation, reduction of the fracture and bone grafting made in computer by Mimics 13.0 were confirmed to be vividly simulate the clinical surgery, and helpful in estimating the amount of bone grafting. Three-dimensional reconstruction and virtual surgical techniques play an important role in assessing and surgical planning of complex tibial plateau fracture before surgery, which should be a conventional step in the management of complex tibial plateau fracture.

Objective To investigate the present situation of quality of life in the elderly residents aged more than 60 years in Zhanjiang city and to analyze its influence factors .Methods 418 elderly residents over 60 years sampled by the random sampling in Zhanjiang city were performed the questionnaire survey by using the Chinese Scale of World Health Organization QOL (WHOQOL-BREF) .Results The quality of life in the physical ,psychological and environmental fields in male residents was higher than that in the female residents ;which in the psychological and environmental fields in the high cultural level residents was higher than that in the low cultural level residents ;which in the social relations field in the high income residents was higher than that in the low in-come residents ;there were no statistical differences in the quality of life among the elderly residents with different occupations be-fore retirement and marital status ;the Logistic regression analysis showed that gender and occupation were the influence factors of quality of life self evaluation in elderly residents .Conclusion Gender ,occupation ,educational level and income level are the influ-ence factors of quality of life in elderly residents .

Objective To establish the normal reference intervals of whole blood trace elements among pregnant women in Han‐gzhou area to provide the clinical diagnostic basis for ensuring the health of pregnant women and their fetuses .Methods A total of 122 whole blood samples in pregnant awaiting delivery in a general hospital of Hangzhou City during 2015 were collected randomly . The levels of lead(Pb) ,cadmium(Cd) ,copper(Cu) ,zinc(Zn) ,nickel(Ni) ,chromium(Cr) ,beryllium(Be) ,manganese(Mn) ,cobalt (Co) ,arsenic(As) ,molybdenum(Mo) ,thallium(Ti) and thallium(Tl) were determined with ICP‐MS .And the results were statisti‐cally analyzed .Results The detection results of whole blood Cu ,Cr ,Mn and Ti showed a normal distribution .The 5% -95% refer‐ence interval was determined according to x ± 1 .96s ,the normal reference intervals for these 4 elements were 255 .37 -668 .23 , 56 .09-151 .93 ,18 .46-54 .60 and 800 .90 -2 632 .02 μg/L respectively .Conclusion Formulating the normal reference values of whole blood microelements levels has an important significance for clinical doctors to provide the nutritional health care guidance and master the heavy metal pollution level .

Objective To observe the prevention effect of glutathione on acute radiation enteritis in pelvic radiation therapy.Methods All 80 pelvic tumor patients treated with radiotherapy were randomly assigned to the control group (40 patients)and the treatment group (40 patients)by the number table method.40 cases in the con-trol group treated with radiation were not treated with preventive drugs,but the patients in the treatment group were treated with glutathione.The occurrence time of acute radiation enteritis and the severity of acute radiation enteritis after treatment were evaluated.Results 15.0% of the treatment group suffered from acute radiation enteritis in the second week and 72.5% in the third week.however,62.5% of the control group were suffered from acute radiation enteritis in the second week and 27.5% in the third week.The difference was statistically significant (χ2 =18.775, 15.998,all P <0.001).Glutathione delayed the occurrence time of acute radiation enteritis.The grade 1 and grade 2 acute radiation enteritis effective rate in the treatment group were 77.5% and 17.5%,and that in the control group were 20.0% and 72.5%,the difference between the two groups was significant(χ2 =26.136,24.139,all P <0.001).The glutathione could reduce the incidence of acute radiation enteritis extent.Conclusion Glutathione could delay the occurrence time of acute radiation enteritis and reduce the incidence of acute radiation enteritis extent.It is worth clinical application.

Objective To study the short-term(≤1 year) effect of video-thoracoscope in the treatment of chronic obstructive pulmonary diseases (COPD) accompanied with pneumothorax.Methods 52 COPD cases with pneumothorax from June 2005 to June 2007 were divided into thoracoscope group(n=28) and open heart group(n=24).The patients were followed up at 1,6 and 12 month after surgery,for determination of BODE index,including body mass index,air block,difficulty in respiratory and motor ability.Results No operative death and servere complicatins occurred.Pneumothorax did not relapse.One month after surgery,air block was[(58.62±15.73)% vs (50.12±11.38)%],difficulty in respiratory was[(1.04±0.37)s vs( 1.72±0.45)s] and motor ability was [(387.32±52.07)m vs (318.35±61.52)m] in thoracoscope group and open heart group (P<0.05).At the six month after surgery,body mass index was[(27.19±2.18)kg/m2 vs (20.90±2.35)kg/m2] in thoracoscope group and open heart group(P<0.05);At the 12 month after operation,there was no significant difierence in BODE index between the two groups(P>0.05).Conclusions Video-thoracoscope in treating COPD with pneumothorax can remarkably improve the quality of life early after surgery.

ObjectiveTo evaluate the effects on serum homocysteine(Hcy) level,vascular function and carotid intima-media thickness(IMT) in metformin-treated diabetic patients with or without supplementation with folate and Vitamin B12.MethodsA total of 100 newly diagnosed diabetic type 2patients were divided into two groups by random digits table with 50 cases each,90 patients completed study.Forty-seven participants (control group) received a 6-month course of metformin treatment,43 patients (treatment group) received mefformin,folate and Vitamin B12 treatment.The levels of serum Hcy,endothelin-1 (ET-1),carotid IMT,large or small arterial elasticity index (C1,C2),flow-mediated dilatation (FMD) of the brachial artery were evaluated before and after treatment.ResultsThe level of serum Hcy in control group significantly increased compared with before treatment[ (13.4 ± 2.7)μ mol/L vs.(11.1 ± 1.9)μ mol/L],hut the level of serum Hcy in treatment group significantly decreased compared with before treatment [ (9.2 ± 1.8 ) μ mol/L vs. ( 11.3 ± 2.0) μ mol/L ],there was significant difference(P ＜ 0.05 ).A beneficial effect was observed in the serum ET-1,FMD,carotid IMT and C2 in treatment group[ (20.0 ± 6.2)ng/L,( 15.8 ± 7.6)％,(0.8 ± 0.2) mm,(4.1 ± 2.1 ) ml/mm Hg ( 1 mm Hg =0.133 kPa) × 100 vs. (31.3 ±10.1 ) ng/L,(9.7 ± 4.5)％,( 1.1 ± 0.4) mm,(2.3 ± 1.0) ml/mm Hg × 100 ] (P ＜ 0.05).The levels of ET-1,FMD,carotid IMT and C2 after treatment in control group [ (24.8 ± 6.8) ng/L,( 12.9 ± 6.3 )％,(0.9 ± 0.3)mm,(3.0 ± 1.4) ml/mm Hg × 100] had significant difference compared with before treatment [ (30.6 ± 8.7)ng/L,(9.8 ± 4.6)％,( 1.0 ± 0.3) mm,(2.2 ± 0.9) ml/mm Hg × 100](P＜ 0.05).However,the results were improved significantly in treatment group than those in control group (P ＜0.05).In treatment group,significant correlation were detected between changes of Hcy and ET- 1 (r =0.43,P ＜ 0.05 ),carotid IMT(r =0.56,P ＜ 0.05),FMD (r =-0.54,P ＜ 0.05 ),C2 (r =-0.37,P ＜ 0.05 ).ConclusionsAdministration of folate and Vitamin B12 can reduce the levels of serum Hcy and ET-1 in metformin-treated type 2 diabetic patients,which exert beneficial effect on carotid IMT,FMD and C2.

Objective To investigate the effect of resveratrol on miRNA-106b in Alzheimer′s disease ( AD ) animal model.Methods Fifty Kunming male mice were divided into five groups by completely randomized block sampling.The five groups included three dosage resveratrol groups , an AD model group and a control group.The AD models were established in one month prior to treatments. Subsequently, from the 31st day various doses of resveratrol were provided intragastricly for 60 days.Then the memory function was observed by the step-down test.Meanwhile, the varying expressions of APP , P62, ApoA1, miRNA-106b, ABCA1 were tested in each group to determine whether there is the binding site for miRNA-106b in APP 3′UTR sequence.Results Compared with the control group by step-down test, the memory function of the AD model group mice decreased in different degree , which in the drug treatment group was higher than that in the model group (P<0.05).Compared with the AD group, the expression of APP (1.131 ±0.035) in the drug treatment group was higher than that in the model group (0.652 ± 0.026), while the P62 (0.412 ±0.022) and ApoA1 (0.534 ±0.032) were lower than the model group ( all P<0.05 ).High and medium dose groups of resveratrol treatment reduced varying degrees of APP (0.733 ±0.018,0.929 ±0.019,F=177.733) levels, and increased P62(0.954 ±0.035,0.633 ±0.015, F=434.5 ) and ApoA1 ( 1.042 ±0.051, 0.824 ±0.034, F=286.582 ) levels ( all P<0.05 ).The expression of miRNA-106b (0.464 ±0.313) and ABCA1(0.293 ±0.042) in the model group was lower than that in the control group (miRNA-106b 1.064 ±0.032, F=238.159; ABCA1 0.781 ±0.027,F=341.61;both P<0.05).The miRNA-106b (0.843 ±0.034, 0.601 ±0.012) and ABCA1 (0.882 ± 0.025, 0.624 ±0.036) levels in the high, medium dose resveratrol treatment groups increased to different extent ( both P<0.05 ).After the drug treatment , luciferase reporter vector experiments showed that the APP 3′UTR sequence contains the binding site of miRNA-106b.Conclusions APP is one of the target genes of miRNA-106b.Resveratrol is capable of improving AD by enhancing the expression of miRNA-106b and down-regulating the target genes including APP , P62 and ApoA1.This provides a new theoretical basis for the clinical treatment of AD.

In the present study, a risperidone loaded microsphere/sucrose acetate isobutyrate (SAIB) in situ forming complex depot was designed to reduce the burst release of SAIB in situ forming depot and to continuously release risperidone for a long-term period without lagime. The model drug risperidone (Ris) was first encapsulated into microspheres and then the Ris-microspheres were embedded into SAIB depot to reduce the amount of dissolved drug in the depot. The effects of different types of microsphere matrix, including chitosan and poly(lactide-coglycolide) (PLGA), matrix/Ris ratios in microspheres and morphology of microspheres on the drug release behavior of complex depot were investigated. In comparison with the Ris-loaded SAIB depot (Ris-SAIB), the complex depot containing chitosan microspheres (in which chitosan/Ris = 1 : 1, w/w) (Ris-Cm-SAIB) decreased the burst release from 12.16% to 5.80%. However, increased drug release rate after 4 days was observed in Ris-Cm-SAIB, which was caused by the high penetration of the medium to Ris-Cm-SAIB due to the hydrophilie of chitosan. By encapsulation of risperidone in PLGA microspheres, most drugs can be prevented from dissolving in the depot and meanwhile the hydrophobic PLGA can reduce the media penetration effect on the depot. The complex depot containing PLGA microspheres (in which PLGA/ drug=4 : 2, w/w) (Ris-Pm-SAIB) showed a significant effectiveness on reducing the burst release both in vitro and in vivo whereby only 0.64% drug was released on the first day in vitro and a low AUC0-4d value [(105.2± 24.4) ng.mL-1.d] was detected over the first 4 days in vivo. In addition, drug release from Ris-Pm-SAIB can be modified by varying the morphology of microspheres. The porous PLGA microspheres could be prepared by adding medium chain triglyceride (MCT) in the organic phase which served as pore agents during the preparation of PLGA microspheres. The complex depot containing porous PLGA microspheres (which were prepared by co-encapsulation of 20% MCT) (Ris-PPm-SAIB) exhibited a slightly increased AUC0-4d of (194.6±15.8) ng.mL-1d and high plasma concentration levels from 4 to 78 days [Cs(4-78d)=(7.8±1.2) ng.mL-1]. The plasma concentration on 78 day C78d was (9.0 2.5) ng.mL-1 which was higher than that of Ris-Pm-SAIB [C78d= (1.6 ± 0.6) ng.mL-1]. In comparison with Ris-Pm-SAIB, the AUC4-78d of Ris-PPm-SAIB increased from (379.0±114.3) ng.mL-1.d to (465.0 ±149.2) ng.mL-1.d, indicating sufficient drug release from the Ris-PPm-SAIB. These results demonstrate that the risperidone loaded porous PLGA microsphere/SAIB in situ forming complex depot could not only efficiently reduce the burst release of SAIB depot both in vitro and in vivo, but also release the drug sufficiently in vivo, and be capable to continuously release the drug for 78 days.

Objective To investigate the risk factors of nosocomial infections in patients with head and neck cancer during radiotherapy .Methods Clinical data of 189 patients with head and neck cancer receiving radiotherapy in Huzhou Central Hospital during August 2011 and December 2014 were retrospectively studied .Chi-square test and multivariate Logistic regression analysis were performed to explore the risk factors of nosocomial infections in patients during radiotherapy .Results Among 189 patients with head and neck cancer receiving radiotherapy , nosocomial infection was observed in 64 (33.86%) patients.Univariate analysis showed that radiation-induced oral mucositis (χ2 =11.47, P<0.01), underlying disease (χ2 =6.59, P<0.05), stage of tumor Ⅲ-Ⅳ (χ2 =4.36, P<0.05), whole-neck radiation (χ2 =7.64, P <0.05), dose of radiation ≥50 Gy(χ2 =8.92, P <0.05), combined chemotherapy (χ2 =6.53, P<0.01), invasive operation (χ2 =4.21, P<0.05), PS score=1 (χ2 =3.58, P<0.05) and low body mass index (χ2 =9.56, P <0.05) were risk factors of nosocomial infections . Multivariate Logistic regression analysis indicated that radiation-induced oral mucositis ( OR=3.46, χ2 =8.72, P<0.01),underlying disease (OR=1.91, χ2 =4.66, P<0.05), stage of tumor Ⅲ-Ⅳ (OR=2.01,χ2 =5.22, P<0.05), whole-neck radiation (OR=1.78,χ2 =4.89, P<0.05), dose of radiation ≥50 Gy (OR=1.69,χ2 =3.25, P<0.05), combined chemotherapy (OR=1.84, χ2 =6.91, P<0.05) and low body mass index (OR=1.53, χ2 =2.59, P<0.05) were independent risk factors of nosocomial infection.Conclusions Nosocomial infections are popular in patients with head and neck cancer during radiotherapy.Radiation-induced oral mucositis, underlying disease, stage of tumor, radiation field, dose of radiation, combined chemotherapy and body mass index are associated with the occurrence of nosocomial infections in these patients .

Objective:To investigate the effects and the possible mechanisms of Neiguan(PC6)and Gongsun(SP4)on the hypothalamic-pituitary-adrenal(HPA)axis in rats with functional dyspepsia(FD),thus to provide a theoretical basis for the clinical application of the Eight Confluent Points.Methods:Forty specific-pathogen-free Sprague-Dawley rats were divided into a blank group,a model group,an electroacupuncture(EA)group,and a Western medicine group by the random number table method,with 10 rats in each group.Rats in the blank group did not receive modeling or intervention.Rats in the other three groups were subjected to the FD with mood disorder model using the compound etiology modeling method.After the successful modeling,rats in the model group did not receive any interventions,rats in the Western medicine group received deanxit and mosaprid intervention,and those in the EA group received EA intervention on the ipsilateral Neiguan(PC6)and Gongsun(SP4)for 21 d.The sugar-water consumption rate was measured before the experiment and before and after interventions to assess the emotional status.The gastric emptying rate was measured after interventions to assess the gastrointestinal dynamics.The expression levels of hypothalamic corticotropin-releasing hormone(CRH),pituitary adrenocorticotropic hormone(ACTH),and adrenal corticosterone(CORT)were measured by enzyme-linked immunosorbent assay.Results:Compared with the blank group,the sugar-water consumption rate and the gastric emptying rate were decreased(P<0.01),and the hypothalamic CRH,pituitary ACTH,and adrenal CORT expression levels were increased(P<0.01)in the model group.Compared with the model group,the sugar-water consumption rate and the gastric emptying rate were significantly increased(P<0.01),while the expression levels of hypothalamic CRH,pituitary ACTH,and adrenal CORT were significantly decreased(P<0.01)in the EA group and the Western medicine group.The differences between the EA group and the Western medicine group were not statistically significant(P>0.05).Conclusion:The Eight Confluent Points Neiguan(PC6)and Gongsun(SP4)can improve the mood and gastrointestinal dynamics in FD rats,which may be achieved by down-regulating the hypothalamic CRH,pituitary ACTH,and adrenal CORT,as well as by correcting the HPA axis hyperfunction.