Objective To explore the treatment methods for brachial artery trauma associated with humeral super-middle fracture.Methods Thirty-two patients of brachial artery trauma associated with humeral super-middle fracture were treated in our department from March 2001 to April 2005 with in tramedallary expanded self-locking nail (IESN) combined with autotransplantation of great saphenous vein to repair brachial artery.Results All patients were followed up for 12 to 18 months,13.6 months on the average.No stenosis occurred at the anastomosed veins according to color Doppler ultrasound.All fractures achieyed clinical healing and the limbs survived well.Conclusion The IESN combined with autotransplantation of great saphenous vein to repair brachial artery is an effective method to treat brachial artery traumaassociated with humeral super-middle fracture,having the advantage of reasonable operation procedure.stabile immobilization and satisfactory functional recovery.

Objective To compare the ability of intentional forgetting to emotional words of post traumatic stress disorder(PTSD) children and normal children by item method after Wenchuan earthquake 18 months.Methods Twenty PTSD children who met with CCMD-3 and DSM-Ⅳ criteria and twenty control group children were investigated. Sixteen positive and sixteen negative words were adopted as materials. PTSD children accomplished the words learning, arithmetical operation and memory tests ( include free recall, words completion and words recognition) in orderly. Results ( 1 )The free recall accuracy of PTSD children to positive words was significant high than negative words( (0.32 ±0.11 ), (0.28 ±0.10), P＜0.05). The free recall accuracy of control group to positive words was significant high than negative words ( (0.37 ± 0.09 ), (0.34 ± 0.13 ), P＜ 0.05 ). ( 2 )The words completion accuracy of PTSD children to positive words was significant low than negative words( (0.38± 0.12 ), (0.49 ± 0.12 ), P ＜ 0.05 ). The words completion accuracy of control group to positive words was significant low than negative words ( (0.39 ± 0.15 ), (0.56 ± 0.14 ), P ＜ 0.01 ). ( 3 ) There was no difference of words recognition accuracy of PTSD children to positive and negative words ( ( 0.64 ± 0. 19 ), (0.63 ± 0. 16), P ＞0. 05). There was no difference of words recognition accuracy of control group to positive and negative words ((0.64 ± 0. 16), (0.65 ±0. 19), P ＞ 0. 05). Conclusion There is a significant intentional forgetting effect on emotional words in PTSD children and normal children, and this effect were influenced not only by selective rehearsal but also retrieval inhibition.

The paper analyzes the necessity to construct the digital resources retrieval platform in hospital.By using heterogeneous database integration technology, it proposes the solution of constructing a one-stophospital digital resources retrieval platform and presents its framework.This retrieval platform can provide human-oriented, differential and intelligent information services and meet the medical staffs'requirements on information resources retrieval to the greatest extent.

Objective To investigate the characteristics of attentional control between Wenchuan earthquake anxious and normal children. Methods Using Screening Child Anxiety Related Emotional Disorders (SCARED), 18 earthquake anxious children were chosen as participants and 18 normal children were chosen as control group. They were asked to perform a visual search task. Results ( 1 ) The judgment accuracy of earthquake anxious children was lower than normal children's significantly ( ( 0.95 ± 0.01 ), ( 0. 98 ± 0. 01 ), P ＜0.01 ). ( 2 ) The reaction time of earthquake anxious children was significantly longer than normal children' s ((1664.5 ± 78.5 ) ms, ( 1110.7 ± 78.5 ) ms, P ＜ 0. 01 ). ( 3 ) There was significantly faster performance in the valid condition than in the neutral( ( 1304.7 ± 61.3 ) ms, ( 1382. 3 ± 47.4 ) ms, P ＜ 0. 05 ) and invalid condition ( ((1304.7 ± 61.3 )ms, (1475.8 ± 71.5 )ms; P ＜ 0. 05 ), as well as faster performance in the neutral than in the invalid condition ((1382.3 ± 47.4) ms, ( 1475.8 ± 71.5 ) ms, P ＜ 0.05 ) in all children. Conclusion The performance of earthquake anxious children on top-down attentional control task is less than normal children. It indicates that anxious emotion which is brought by traumatic incidents like earthquake influents earthquake anxious children' s cognitive processing ability.

Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in cardiac valvular diseases.Methods Preoperative and postoperative RT-3D-TEE studies were performed in 32 patients who had undertaken cardiac valve repair or valvular replacement using Philips iE33 with X7-2 probe,and quantitative analysed the mitral structure in cases of mitral valve prolapse by using online QLAB7.0 quantitative analysis software.Results RT-3D-TEE can demonstrate the anatomicsl structure clearly,evaluate the function of cardiac valves precisely,and reveal details of type,position and extent of lesions vividly in surgical view.RT-3D-TEE helped correct misdiagnose in 2 cases,revised surgical plans in 3 cases,and guided implementation of remedial surgery in 1 case.Conclusions RT-3D-TEE can present images lively,and it can provide adequate information for preoperative diagnosis,aid the formulation of surgical plan and evaluate surgical effect.

Objective To evaluate the effect of mitochondrial permeability transition pore (mPTP) in lipid emulsion-induced inversion of bupivacaine myocardiotoxicity in rats.Methods H9c2 cells were inoculated in 6-well plates at a density of 105 cells/ml, and were randomly divided into 4 groups (6 wells in each group, 2 ml/well) using a random number table: control group (group C) , bupivacaine group (group B) , lipid emusion + bupivacaine group (group LB) , and lipid emusion + bupivacaine + atractyloside group (group LBA).Phosphate buffer solution 100 μl was added to the culture medium in group C.In group B, bupivacaine was added to the culture medium with the final concentration of 1 mmol/L.In group LB, lipid emusion and bupivacaine were added to the culture medium with the final concentrations of 1％ and 1 mmol/L, respectively.In group LBA, lipid emusion, bupivacaine and atractyloside (an mPTP opener) were added to the culture medium with the final concentrations of 1％, 1 mmol/L and 30 μmol/L, respectively.All the cells were incubated for 24 h.After the end of incubation, the expression of Bcl-2, Bax, phosphorylated Bad (p-Bad) , caspase-3, activated caspase-3, caspase-9,activated caspase-9 and cytochrome c (Cyt c) was detected using Western blot.The expression of Bcl-2 mRNA, Bax mRNA, Bad mRNA, caspase-9 mRNA and Cyt c mRNA was detected using real-time reverse transcriptase polymerase chain reaction.The ratios of Bax/Bcl-2, activated caspase-3/caspase-3, activated caspase-9/caspase-9, and Bax mRNA/Bcl-2 mRNA were calculated.Results Compared with group C,the ratios of Bax/Bcl-2, activated caspase-3/caspase-3, activated caspase-9/caspase-9, and Bax mRNA/ Bcl-2 mRNA were significantly increased, the expression of p-Bad was down-regulated, and the expression of Cyt c, Bad mRNA, caspase-9 mRNA and Cyt c mRNA was up-regulated in group B (P＜0.05) , and no significant change was found in the parameters mentioned above in group LB (P＞0.05).Compared with group B, the ratios of Bax/Bcl-2, activated caspase-3/caspase-3, activated caspase-9/caspase-9, and Bax mRNA/Bcl-2 mRNA were significantly decreased, the expression of p-Bad was up-regulated, and the expression of Cyt c, Bad mRNA, caspase-9 mRNA and Cyt c mRNA was down-regulated in LB and LBA groups (P＜ 0.05).Compared with group LB, the ratios of Bax/Bcl-2, activated caspase-3/caspase-3, activated caspase-9/caspase-9, and Bax mRNA/Bcl-2 mRNA were significantly increased, the expression of p-Bad was down-regulated, and the expression of Cyt c, Bad mRNA, caspase-9 mRNA and Cyt c mRNA was up-regulated in group LBA (P ＜ 0.05).Conclusion The mechanism underlying lipid emulsioninduced inversion of bupivacaine myocardiotoxicity is related to inhibited mPTP opening in rats.

Objective: To assess the trend of early beta receptor blocker (β-blocker) application (with 24h of admission) for acute myocardial infarction (AMI) patients in western rural China from 2001 to 2011. Methods: A 2-stage random sampling design was performed. The 1st stage: a simple random sampling was used to identify participating hospitals and the 2nd stage: a systematic random sampling approach was conducted in 3 specific years of 2001, 2006 and 2011 to take case study for central medical information abstraction. The changing trends and impact factors of early β-blocker application for AMI patients in western rural area were assessed by multivariate model analysis. Results: 35 hospitals were sampled and 33 of them were finally participated. With necessary exclusion, a total of 486 AMI patients without β-blocker contraindication were enrolled for 2 groups: Suitable group, the patients were suitable for early β-blocker application, n=247 and High risk group, the patients with the high risk for shock occurrence, n=239. The application rates for β-blocker within 24h of admission at 2001, 2006 and 2011 in Suitable group were 19.06%, 54.30% and 56.20%, Ptrend=0.0020; in High risk group were 31.53%, 59.49% and 69.62%, Ptrend=0.0001. In Suitable group, the patients with history of hypertension (OR=1.87, 95% CI 1.06-3.29), smoking (OR=1.97, 95% CI 1.11-3.48) or admitted in 2006 (OR=2.93, 95% CI 1.22-7.03) and 2011(OR=4.67, 95% CI 2.06-10.59) had the higher chance to use β-blocker within 24h of admission. Conclusion: Application of β-blocker within 24h of admission in AMI patients presented the increasing trend in western rural China from 2001 to 2011, while there was still difference from the guideline recommendation. Improved normative application of β-blocker is helpful to enhance the quality of care and prognosis in AMI patients.

Objective: To assess trends of β-blocker use within 24h of admission in ideal candidates with acute myocardial infarction (AMI) in eastern urban China from 2001 to 2011. Method: A 2-stage random sampling design was performed. In the first stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select cases from the participating hospitals. Data was obtained by central medical record abstraction. 10-year trend and predictors of early β-blocker application were assessed with weighted calculation for each year to represent the overall situation of eastern urban China. Results: 35 hospitals were sampled and 32 of them were finally participated. With necessary exclusion, 1399 ideal candidates were included in this analysis. The early weighted β-blocker application rates in 2001, 2006 and 2011 were 64.7%, 69.7%, and 60.9% respectively, P=0.0447 for trend. Patients with chest pain at admission (OR=2.22, 95% CI 1.19-4.13), higher systolic blood pressure (OR=1.40, 95% CI 1.11-1.77) or faster heart rate (OR=2.01, 95% CI 1.58-2.55) were more likely to use β-blocker; in contrast, compared with NSTEMI patients, STEMI patients seemed less likely to receive such treatment (OR=0.55, 95% CI 0.37-0.81). Conclusion: The early β-blocker therapy in eastern urban China is suboptimal for ideal AMI patients who could benefit from it. The application pattern has not been changed from 2001 to 2011 which might be related to physicians' misunderstanding of relevant evidence or guidelines. Our study may help to create an important target to improve the quality of AMI care.

Objective To discuss the selection and application of internal fixators in the treatment of aged patients suffering from femoral condyle fracture. Methods 82 aged patients with femoral condyle fracture were treated from February 1995 to June 2002. According to AO/ASIF classifcation,26 cases were classified as type A,17 cases type B, and 39 cases type C. They were treated with internal fixation by 95?angle plate (19 cases), T type plate(5 cases), AO condyle supporting plate (11 cases), dynamic condylar screw (DCS) (23 cases) and Green Seligsen Henry (GSH) (24 cases). Measures of auto ilium transplant or homologous allograft bone transplant (28 cases) were also taken. Results All the cases were followed up for an average of 14.6 months. Merchan grading method was applied to evaluate their knee joint functions. The total excellent and good rate was 90.2%. Conclusions Aged patients with femoral condyle fracture should be treated specially. The fixation should be chosen according to their fracture type so as to ensure fine clinical results. The goal of the operation is to keep the integrity of articular surface of the femoral condyle and to acquire secure internal fixation.

Objective To study the ultrastructure of the renal papillary Randall's plaque in calclum oxalate stone formers. Methods The 14 biopsy samples of the Randall's plaque in 12 patients with calcium oxalate stone undergoing PCNL for stone removal were obtained using endoscopic biopsy technique,followed by staining with hematoxylin-eosin or fixing with osmium tetroxide,and then the ultrastructure of the Randall's plaque was observed under light microscope and transmission electron microscope. Results In all 12 patients,72 renal papillae were examined.All kidReys were found to have papillary plaque and 7 of the patients had attached stones.Sixty-three papillae(87.5%)contained plaque.Calcium deposition was seen in the 12 renal papilla tissue by light microscopy.Transmission electron microscopy images of the 2 Randall's plaque samples showed several cluster of sharp and large crystals lied closer to the surface of Randall's plaque.The typical crystals were acicular with light profile. Conclusions Randall's plaque is an interstitial medullary and papillary deposit of calcium oxalate.The appearance of the deposition of calcium oxalate crystals lies upon Randall's plaque,which might be an explanation for the mechanism of calcium oxalate stone formation.