Objective To investigate the operative treatment of displaced intra-articular fractures of the calcaneus using a small lateral incision approach.Methods Thirty-one patients with 32 intra-articular calcaneal fractures,were treated with open reduction and internal fixation through a small lateral incision approach from October 2004 to April 2006.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.According to Sanders classification,there were 21 typeⅡfractures and 11 typeⅢfractures.The first change of dressing was done on the second day after operation.The residual blood clots in the wounds were cleaned as much as possible when the drainage sheet was removed.The operated foot was bandaged with pressure dressing of cotton pad.Results After an average follow-up of 10.5 months(range,3 to 18 months),no soft tissue com- plications were found,and all had acceptable reduction.The preoperative X-ray film showed that B(?)hler angle was 6.84??9.36?,Gissane angle was 106.04??12.03?.The postoperative X-ray film demonstrated that B(?)hler angle was 32.06?+6.87?,Gissane angle was 115.81??9.48?,and the difference was statistically significant(P＜0.01).According to the AOFAS evaluation system for Ankle-Hindfoot,two feet scored 60-70 points,nine feet 70-80 points,16 feet 80-90 points and five feet 90-100 points.Condusion The small lateral incision approach is a good option for management of calcaneus fractures,because it causes minimal soft tissue damage,provides excellent exposure,and leads to convenience for later removal of internal fixators and subtalar arthrodesis.

The effects of highly active antiretroviral therapy (HAART) to patients with AIDS in Hubei province of China were investigated in order to provide scientific evidence to reinforce the management of HAART. Self-made questionnaires and descriptive method of epidemiology were used to collect and describe the changes of clinical symptoms, HIV RNA concentration, and immune function of patients with AIDS. After HAART, the effective rate of fever, cough, diarrhea, lymphadenectasis, weight loss, tetter, debility and fungous infection was 92.4%, 90.85%, 92.91%, 90.73%, 93.69%, 89.04%, 92.34%, and 83.1%, respectively. Of 117 patients with detected HIV RNA concentration, 41.03% had declined over 0.5 log, and 52.99% less than 0.5 log. CD4(+)T cell count was obviously increased: the average number after HAART for 3 or 6 months was 237/microL (26-755/microL) and 239/microL (17-833/microL), respectively. HAART can improve AIDS patients' clinical symptoms, reduce HIV RNA concentration, and maintain immune function. It is very important for the effectiveness of HAART to raise clinical adherence of patients with AIDS and have a persistent surveillance.

Objective To summarize the experience of minimally invasive treatment in upper ureteral calculi complicated with urinary tract infection.Methods Retrospectively analyzed the clinical data of 40 cases with upper ureteral calculi complicated with urinary tract infection who were treated from December 2009 to December 2013.Results Twenty-one cases were performed with retrograde catheterization at cystoscopy and 11 cases were performed with percutaneous nephrostomy directed by B-ultrasound in the stage Ⅰ,the infection were controlled after operation 2-6 d.These patients were successfully cured by extracorporeal shock-wave lithotripsy (ESWL),ureterorenoscope lithotripsy (URL) or percutaneous nephrolithotomy (PCNL) in the stage Ⅱ].The remaining 8 cases were successfully cured by URL with antiinfection therapy in the stage Ⅰ.All patients had no ureteral perforation,laceration,urine derived sepsis and severe bleeding complications.All of ureteral calculi were drained after 2-10 weeks.The average hospital stay was 13.4 d.Patients were followed up for 1-12 months after the stone expulsion,the average was 6 months.There was 3 patients who with preoperative renal dysfunction had been improved after URL,and other patients' renal function returned to normal.Conclusions The therapy of retrograde catheterization at cystoscopy and percutaneous nephrostomy directed by B-ultrasound in the stage Ⅰ,combined with ESWL,URL or PCNL in the stage Ⅱ in treating upper ureteral calculi complicated with urinary tract infection have more advantage such as less complication,rapid control of infection and complete removal of stones.It is an ideal method.

Objective To investigate early and differential diagnosis of Alzheimer disease and vascular dementia (VD)using FDG-PET scan. Methods Clinical data was collected from AD,VD and normal control(NC). 18F-2-fluo-ro-deoxy-D-glucose(18F-FDG)PET scan was conducted to detect the cerebral FDG metabolism. The average standard uptake value (SUV) of cerebral regions was expressed as semiquantitative index relative to ipsilateral cerebellum. Re-sults There were no differences in age and the mean total scores of the mini mental status examination (MMSE) between patients with VD and those with AD.The AD group showed that the SUV was significantly decreased in the right frontal, parietal,temporal lobe,hippocampus,temporo-parietal junction,and bilateral posterior cingulate cortex compared to the VD and in the bilateral posterior cingulate cortex,temporo-parietal junction,frontal and temporal lobe comparing to the NC(P≤0.01). SUV was significantly increased in the right parietal,posterior cingulate cortex and hippocampus whereas was significantly decreased in the left frontal lobe,temporo-parietal junction and thalamus in the VD compared with NC group(P≤0.01). Conclusion AD patients have typical features of 18F-FDG PET which may be helpful for the diagnosis of AD in the early stage.

Objective To evaluate the safety, performability and long-term clinical efficacy of stenting angioplasty for treating symptomatic internal carotid artery (ICA) stenosis in the origin part in elderly patients. Methods Stenting angioplasty was performed on 29 patients with symptomatic ICA stenosis in the origin part. Results 29 stents were placed in 29 patients. Operations were performed 100%successfully. After an average 24 months of follow-up visits, restenoses were detected in 2cases reexamined by DSA 6 months after stenting, both presented with less than 50% stenoses. 1 case was found not regularly taking statins and antiplatelet drugs after stenting, severe restenosis occurred 6 months later, stent implantation performed again, no recurrence of transient ischemic attack (TIA) was noted during 2 years′follow-up visit. Cerebral ischemic strokes occurred in 2 cases , and both of them had balloon dilatation after stenting. 1 case was completely recovered after treatment and 1 was left with weakness in right extremities, unabling to walk. No cases of posterior circulation ischemia, death and myocardial infarction were detected. Conclusions Stenting angioplasty can be performed in treating symptomatic internal carotid artery stenosis in elderly patients. It showed a relatively good mid-long-term clinical effects and can be a secondary prevention option.

Purpose To clarify the role of KAI1/CD82 in metastasis of nasopharyngeal carcinom and to evaluate the clinical efficacy of KAI1/CD82-expressing EPCs in the prevention of nasopharyngeal carcinoma.Method Umbilical vein-derived EPCs were infected with KAI1/CD82-expressing lenti-virus to get a KAI1/CD82-overexpressing EPC cell line (KAI1/CD82-EPCs).A xenograft mouse model of human nasopharyngeal carcinoma was established,and KAI1/CD82-EPCs were injected through the tail vein.The effect of the KAI1/CD82-EPCs on growth and metastasis of the xenograft was observed.Results Time required for tumor formation was 14.70 ± 3.81,15.05 ±3.85,14.20 ± 3.55 days respectively for the EPCs,EPCs-NC,and KAI1/CD82-EPCs groups,with no significant difference among the three groups (P =0.771).Weight of the xenograft was (1.388 ±0.204) g,(1.487 ±0.223) g,(1.485 ±0.234) g respectively for the EPCs,EPCs-NC,and KAI1/CD82-EPCs groups,with no significant difference (P =0.274).Rate of lung metastasis was 55％,45％ and 10％ for the EPCs,EPCs-NC,and KAI1/CD82-EPC groups,and the difference was significant (P =0.005).Number of metastatic lesions was 34.27 ± 5.35,38.44 ± 9.63,17.50 ± 3.54 for the three groups,and the difference was also significant (P =0.007).Immunohistochemistry indicated positive KAI1/CD82 expression in metastatic lesion of the KAI1/CD82-EPCs group,but no KAI1/CD82 expression in the EPCs group or EPCs-NC group.Conclusion KAI1/CD82-expressing EPCs inhibits lung metastasis of the xenograft mouse model of human nasopharyngeal carcinoma.

Objective:To evaluate the diagnostic values of serum fibrinogen and D-dimer for periprosthetic joint infection (PJI).Methods:The medical records were retrospectively analyzed of the 175 patients who had undergone hip or knee revisions at Department of Joint Surgery, Affiliated Hospital to Qingdao University from August 2013 to June 2019. Of them, 59 were diagnosed as PJI (31 knees and 28 hips), including 33 males and 26 females with an age of (67.4±11.7) years and a body mass index (BMI) of (26.1±3.6) kg/m 2 while 116 as aseptic loosening (AL) (19 knees and 97 hips), including 67 males and 49 females with an age of (70.3±8.9) years and a BMI of (25.0±3.6) kg/m 2. The plasma levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen and D-dimer in the 2 groups were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to calculate the sensitivity and specificity of each indicator; the diagnostic value for each indicator was calculated according to the area under the curve (AUC). Results:There was no significant difference between the PJI and AL groups in gender, age or BMI ( P>0.05), but there was a significant difference in the joint type ( P<0.05). Compared with the AL group, the PJI group had significantly higher levels of CRP, ESR, fibrinogen and D-dimer ( P<0.05). The AUCs for CRP, ESR, fibrinogen and D-dimer were 0.830, 0.850, 0.848 and 0.664, respectively. By the Youden index, the optimal predictive cutoffs for CRP, ESR, fibrinogen and D-dimer were 8.06 mg/L, 17.60 mm/h, 3.73 g/L and 685.00 ng/mL, giving sensitivities of 79.2%, 85.4%, 81.3% and 64.6% and specificities of 85.7%, 76.2%, 79.8% and 61.9%. Conclusions:The diagnostic value of serum fibrinogen may be high for PJI, similar to that of CRP or ESR. However, D-dimer may be of limited value for diagnosis of PJI.

Objective To assess the quantitative relationship between the distribution of Himalayan marmot and its ecological environment,the terrain,the temperature and the precipitation,using remote sensing and geographic information system in Qinghai province.Methods The distribution of Himalayan marmot was located by Google Earth and ArcGIS software and by using field survey data provided by Chinese Center for Disease Control and Prevention.The corresponding ecological environment of marmot including terrain,temperature and precipitation were derived from the spatial information datasets.All results were processed according to the overlay and statistics analysis using ArcGIS software.Results Seventy-seven point twenty-seven percent(153/198) of Himalayan marmot were distributed in the area of elevation between 3000 and 4000 meters.The number of marmot reached the highest when the slope was between 0 and 17 degrees,and aspect range was between 91 and 270 degrees,180 degree was as south direction.During the period with the maximum temperature of the warmest month of 14.3-17.5 ℃,17.6-20.8 ℃ and 20.9-24.0 ℃,the distribution of marmot reached 95％(186/198) of the total area.Meanwhile,most of the marmot were presented in the area with average precipitation of 46-108 mm.Conclusions A quantitative analysis of appropriate ecological environment of Himalayan marmot in a large scope is carried uul successfully using remote sensing and geographic information system.The study indicates that spatial information technology has important applications in plague prevention and control.

Background Human paired box gene 6 (PAX6)encodes a transcriptional regulator.It is essential for eye and brain morphogenesis.Mutation of PAX6 gene isresponsible for many congenital ocular malformations,such as aniridia.Aniridia is a autosomal dominant inheritance mode.Objective In this study,PAX6 gene mutation was analyzed in three Chinese families with aniridia through polymerase chain reaction (PCR) and sequencing.Methods The blood specimens were collected from 5 suffers and normal individuals of 3 aniridia families to extract DNA.The sequences of extron 4-13 were designed based on PAX6 gene.The primer was amplified by PCR and sequenced and compared with the known PAX6 gene sequence.This study complied with Declaration of Helsinki and approved by ethic committee of Sichuan University.Written informed consent was obtained from each individual before any medial examination.ResultsThere were 5 suffers in the 3 families.A heterozygous mutation (c.718 C＞T) in PAX6 gene was identified in 2 patients of family A.This mutation caused an amino acid substitution of arginine to termination codon at position 240 ( p.Arg240X) of PAX6 protein.No similar change in the normal families.No any the alteration of PAX6 gene was detected in family B whatever suffers and normal individuals.In family C,a deletion mutation of c.331 delG ( p.Val111 SerfsX13 ) in PAX6 gene was found.The deletion of one base caused frame shift mutation of PAX6 protein,and no such mutation was seen in other families.Conclusions Mutation of PAX6 gene appeares to be causative mutations of the disease in family A and C.