Objective To discuss the ultrasonic anatomy of gastrocnemius and its substructures in normal population. Methods Eighty gastrocnemius in 40 volunteers were scanned by real time high frequency ultrasound. Sonograms of medial and lateral heads of gastrocnemius were acquired. Plume angles between medial and lateral heads of gastrocnemius were measured at condition of rest, 5 kg and 10 kg isometric contraction. Both dominant and non-dominant legs were evaluated. Differences of plume angles were compared by ANOVA in different conditions and by t test in different legs. Results At the upper part of the muscle, both medial and lateral heads of gastrocnemius could be divided into muscular compartment, shallow compartment and deep compartment by hyperechoic intra-muscular septa with clear margin. The septa of lateral heads presented as hyperechoic side-lying′T′, while the septa of medial heads presented as hyperechoic side-lying-′T′. Vascular signals could be detected in these hyperechoic septa. The plume angle at the distal part of the lateral head of gastrocnemius was composed of shallow compartment attaching to the Achilles tendon, and that of the medial head was composed of medial muscular compartment attaching to the tendon. At rest, 5 kg and 10 kg isometric contraction, plume angles of lateral heads were (13.36±3.20)°, (13.32±3.30)° and (12.75±3.20)°, and plume angles of medial heads were (8.69±3.30)°, (8.59±2.99)° and (8.65±3.20)°. Under the same condition, plume angles of medial heads were larger than those of lateral heads and the difference was statistically signiifcant (t=9.09, 9.50 and 8.10, all P<0.01). Changes of plume angles between rest and different weight bearing conditions were small, and differences were not statistically signiifcant (F=0.89 and 0.02, P=0.41 and 0.98). Plume angles of medial heads in dominant legs and non-dominant legs were (13.66±3.60)° and (13.30±2.84)°, and those of lateral heads were (8.71±3.48)° and (8.80±3.35)°. The plume angles of medial heads were larger in dominant legs than those in non-dominant legs, while the plume angles of lateral heads were smaller in dominant legs than those in non-dominant legs. However, both differences were not statistically signiifcant (t=0.70 and 0.87, P=0.48 and 0.17). Conclusions The anatomical characteristics of medial and lateral heads and compartments of gastrocnemius can be clearly depicted by high frequency ultrasound. Plume angles can also be accurately measured.

Objective To design and manufacture an external fixator for close reduction of fibu la and tibial fractures.Methods The all-ring reduction and fixation system made of duroplasts comprises three main parts:two reduction rings with gears and worms,two modulation frames to correct lateral or anteroposterior re-placement,and four connecting rods.By cranking the handle,the gears wi ll be driven,which may in turn shift t he modulation frame,then the needle co nnecting the bone with the frame can s hift the fracture ends in three dimen sions and six freedom degrees.After reduction,the fracture is fixed by the cro ssed needles linked to several groups of half-ring fixation arms,which can b e shifted and locked onto the linking rod properly.Results The apparatus was used in 32patients.All cases got anatomic reduction,and the curativ e ratio was 100%.Conclusion The external fixator for close reductio n of tibial and fibula fractures has g ood reduction and fixation effect,a nd the design provides a very good clinical therap eutic method for close reduction of t ibial and fibula fractures.[

Objective To probe into the present family bed workloads at community health centers in Shanghai,for bettering the service mode.Methods 41 community health centers in 17 districts or counties in Shanghai were randomly sampled with questionnaires,to learn the profile of the family beds and analyze the workloads provided by the institutions from 2010 to 2012.Results For the 41 institutions surveyed,patients aged 60 or above accounted for 95.07％ of the total patients,of whom the seniors over age 80 accounted for 51.00％; 3-year family bed setup rate is 4.45‰,5.09‰ and 5.51‰ respectively;the family bed checkup interval is 6.26 days,6.08 days and 5.84 days respectively.The average monthly payment from medical insurance per person is 441.86 yuan in 2010,433.41 in 2011,and 401.26 in 2012.Diseases makeup:Cardiovascular diseases accounting for 51.16 ％of the total,stroke patients for 31.02 ％,chronic bronchitis for 4.81％,and cancer patients for 1.10％.Among those patients withdrawn from family beds,86.54％ were cured,steady plus improvements.Conclusion Further improvement of the family bed service for better elderly chronic care management; preferential policies to further enhance the family bed service capabilities; emphasis of internal management to continuously improve the social benefits.

Receptor-mediated gene transfer has many advantages such as cell and tissue targeting, high efficiency, high safety, low immunogenicity and easy-to-produce. This article briefly reviews the recent developments on receptor-mediated gene transfer technology, including its main types, effect factors and tactics to augment gene transfer efficiency.

Objective To study change of insulin resistance and beta-cell function of the patients in hyper-tension with normal glucose tolerance(NGT) to phthogonesis of type 2 diabetes mellitus(T2DM). Methods 84 pa-tients with hypertension were divided into NGT group,and groups of impaired glucose tolerance(IGT) with groups of T2DM. The blood pressure, height, weight, waist circumference, hip circumference, high-density lipoproteins (HDL-C)and total cholesterol(TC) ,fasting plasma glucose(FPG) and fasting plasma insulin(FINS) were measured to deter-mine the body mass index(BMI) ,waist/hip ratio(WHR) ,insulin secretion function[ including Homa β-cell function index(HBCI) and fasting β-cell function index(FBCI)] and insulin resistance level [ including Homa model insulin resistance index(IR) and insulin action index(IAI)] ,statistic comparison were measured between the groups of dif-ferent glucose tolerances. Results The BMI, WHR, diastolic blood pressure ( DBP), TC in IGT group and T2DM group were bigger or higher than those in NGT group ( P<0.05, P<0.01 ), the IAI, HOMA-IS and FBCI in T2DM group were lower than those in NGT group with these in NGT group were lower than those in NGT group( P<0.05 ,P<0.01 ). The HOMA-IR in IGT group and T2DM group were higher than those in NGT group with these in T2DM group were higher than those in NGT group. Conclusion T2DM group and IGT group had more insulin resistance level,sensitivity of insulin and islet β-cell function decrease than those in IGT group,the IGT group and T2DM group are analogous at the body weight is heavier, with waist/hips ratio, triglyceride level and DBP are higher than those in the NGT group in clinic.

Objective To investigate the inhibitory effect of proliferation and invasiveness on PANC1 cell by knockdown of NF-κB P65 expression through RNA interference. Methods Chemically synthesized small interference RNA (siRNA) directed against human NF-κB p65 was transfected into pancreatic carcinoma cell (PANC1) by using cationic liposome LipofectamineTM 2000 as the transfection agent. A non-silencing siRNA was used as the negative control and distilled water was used as the blank control. The tests repeated for six times. The expression of NF-KB p65 and ICAM-1 gone was detected by RT-PCR. The effect of cell proliferation and invasive ability was evaluated by MTF, clony assay, Matrigel invasive tests. Results The relative expression levels of NF-κB p65 mRNA in siRNA, the negative control and the blank control group were 0.227 ±0.045, O. 381 ± 0. 038 and 0. 404 ± 0. 031, respectively; the relative expression levels of ICAM-1mRNA were 0.597 ± 0. 083, 0.983 ± 0.068 and 1. 027 ± 0.098, respectively; the inhibitory rate of the cells at 72h were 18.3%, 2.3% and 0, respectively; the colony forming efficiency were ( 14.1 ± 3.1 ) %, ( 24.5±2.1)% and (27.2 ±2.6)%, respectively; the number of invasive cells were 80.25 ±6.35, 123.83 ±8.80 and 127.68 ± 9.23, respectively; the difference between the siRNA group and two control groups was significant (P ＜ 0. 01 ). Conclusions Down-regulatiag the expression of NF-κB p65 gene by RNAi may inhibit proliferation and invasiveness in pancreatic carcinoma cell strain PANC1.

Objective To study the effects of injecting recombinant human granulocyte colony stimulating factor (rhG-CSF) and basic fibroblast growth factor (bFGF) alone or combined on actue myocardial infarction(AMI).Methods AMI models were induced by ligation of the left anterior descending artery.The survived rats were divided into four groups randomly:AMI group (MI),rhG-CSF group (G),bFGF group (B),combined group (GB).Respectively,saline,rhG-CSF,bFGF,and rhG-CSF plus bFGF were injected intraperitoneally 24 h after AMI.Also,sham-operated group (S) was established with only chest-opeaned,without ligation,and no drugs intervention. The white blood cells (WBC) and mononuclear cells (MNC) proportion in peripheral blood were counted 1 week before and 1 week after the intervention,and the number of CD34+ cells was observed with immunohistochemical staining 1 week after AMI in order to compare the situation of mobilization in peripheral blood;the capillary density was evaluated by HE staining both 1 and 4 weeks after AMI;their cardiac fuction was determined in vivo,the infarction size in each group was calculated,and the pathological changes in rat myocardium were observed by HE staining 4 weeks after AMI.Results Compared with MI group,the number of WBC and MNC% in peripheral blood 1 week after AMI in G,B and GB groups were higher(P

Objective To investigate the relationship between the onset of lower extremity venous thrombotic disease and seasons.Methods A retrospective study was conducted, 300 patients with lower extremity venous thrombotic disease admitted to HandanCity Hospital of Traditional Chinese Medicine (TCM) from August 2012 to February 2014 were enrolled, the incidences and TCM syndromes of patients with lower extremity venous thrombotic disease in different seasons were observed, and the pathogenesis and relationships between the types of TCM syndrome and seasons were analyzed.Results There were 142 patients with lower extremity superficial thrombophlebitis, and 158 cases with lower extremity deep venous thrombosis, the incidence of lower extremity venous thrombotic disease in spring was significantly higher than that in summer and autumn [32.8% (86/262) vs. 21.3% (54/254), 18.4% (50/272), bothP < 0.01], but lower than that in winter [32.8% (86/262) vs. 37.2% (110/296)], the difference was not statistically significant (P > 0.01); while the incidence of lower extremity venous thrombotic disease in winter was significant higher than those in summer and autumn (allP < 0.01). The incidences of damp and heat downward flow type in autumn and summer were increased compared with those in winter and spring [55.6% (30/54), 60.0% (30/50) vs. 20.0% (22/110), 23.3% (20/86), allP < 0.01], while the incidences of lower extremity venous thrombotic disease with damp heat and stasis syndrome in winter and spring were increased compared with those in summer and autumn seasons [80.0% (88/110), 76.7% (66/86) vs. 44.4% (24/54), 40.0% (20/50)].Conclusions The incidence of lower extremity venous thrombotic disease is related to seasons, and the onset is high in winter and spring, damp heat and stasis syndrome being the main type; according to different seasons, clinical treatment can direct to different pathogenic factors to adopt different preventive measures interfering with the patient's constitution in order to eliminate or reduce the risk factors, achieving the effect of the disease prevention.

Objective To investigate the antitumor effect and its mechanism of microbubble contrast combined with Mitoxantrone exposed to low-frequency ultrasound on human breast cancer cell MCF-7. Methods MTT method was applied to examine the growth inhibition of MCF-7 treated with Mitoxantrone. MCF-7 cells were randomly divided into 4 groups:Mitoxantrone group (group D), ultrasound+Mitoxantrone group (group U+D), ultrasound+microbuble +Mitoxantrone group (group U+M+D) and control group (group C). The cytoactive of each group was examined with MTT. The intracellular drug content in each group was measured with high performance liquid chromatography. The morphology of MCF-7 cells apoptosis was observed with transmission electron microscopy (TEM). Results The IC_(50) of Mitoxantrone was 2.87 μg/ml. The differences of cytoactive among all groups were significant (P<0.05). The intracellular drug content of group U+M+D was higher than that of group U+D, and the latter was higher than that of group D. The morphological changes of apoptosis were observed with TEM. Conclusion Low-frequency ultrasound can promote intracellular drug content as to enhance the sensitivity of chemotherapy drugs on tumor cells, and this effect can be enhanced by microbubble contrast exposure to low-frequency ultrasound.

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .