Objective To evaluate the effect of vacuumassisted closure (VAC) combining surgical treatments on chronic osteomyelitis after severe open fractures. Methods Fifty-eight patients with severe high energy open fractures were enrolled,35 patients were randomized to the experimental group and had identical treatment except that VAC was applied to the wounds between irrigation and debridement procedures, 23 patients were randomized to the control group and underwent initial irrigation and debridement followed by standard fine mesh gauze dressing. The infection rate, therapeutic effect and health condition were evaluated between the two groups. Results All patients were followed up for 14 - 36 (28.0 ± 7.3 ) months.Control group developed 7 cases ( 30.4%, 7/23 ) with deep infections, whereas experimental group developed 2 cases (5.7%,2/35) with deep infections. There was significant difference between the two groups (P =0.024). There were 24 cases (68.6%,24/35) grade A healing in experimental group,whereas there were 13cases (56.5%, 13/23) grade A in control group,the difference was very singificant (P＜0.05). The health total score of experimental group was higher than that of control group at 3,9 months after operation (P =0.013,0.005). Conclusions Patients treated with VAC have a higher recovery rate,shorter length of stay and satisfactory curative effect compared with patients randomized to the traditional methods. VAC represents a promising new therapy for osteomyelitis after severe open fractures.

Objective To investigate the changes and role of elastic fibers during the progression of ventricular remodeling after myocardial infarction(MI) in rats. Methods Male Sprague Dawley rats were induced by ligating the anterior descending coronary artery and were divided into the 2nd,4th,8th,12th and 21st week groups.Elastic fibers were evaluated in the infarct region using Masson trichrome staining,Uana orcein staining and image analysis.The expressions of TNF? and IL-1? were also detected by immunohistochemistry. Results Elastic fibers could be found within the infarct region in the 2nd week after MI,increased with time and reached the peak during the 8th to 12th weeks,decreased or were absent in the 21st week.The expressions of TNF-? and IL-1? were also detected in the infarct zone and increased with time.Conclusion Elastic fibers were involved in infarct healing and may play an important role in promoting ventricular remodeling.

Objective To analyze the characteristics and changes in the disease spectrum of Air Force(AF) servicemen in order to provide reference for the determinatron of the overall level of health of AF and priorities of disease prevention and control.Methods The data of outpatient and inpatient diseases between 2009 and 2013 in AF was collected and analyzed statistically according to the International Classification of Diseases-9(ICD-9),and statistical description was performed with SPSS18.0.Results Between 2009 and 2013,unit B had the highest number of outpatients and inpatients,accounting for 47.74% and 39.64% respectively.The upper respiratory tract infections,gastroenteritis/gastritis,chronic low back pain,skin diseases,nasal sinusitis,training injury,trauma,hemorrhoids,varicocele and stone diseases were the common and frequently occurring diseases in AF,which were the top ten in the disease spectrum.Among them,the incidence and admission rate of skin diseases kept declining.However,the incidence of gastroenteritis/gastritis in unit A,the incidence and admission rate of chronic low back pain in unit B and D,the incidence of injury in unit D,as well as the incidence of neurological headache and hypertension in unit C and D were higher than in other units.Conclusion Respiratory system disease,and occupation-related diseases such as low back pain,training injuries,trauma,skin disease and digestive system disease are the focus of health care in AF.Health education and health promotion for these diseases should be improved,and health intervention for key populations should be enhanced.

Objective To evaluate the effectiveness of intratracheal injection of pulmonary surfactant (LISA) combined with continuous positive airway pressure (CPAP) on the treatment of neonatal respiratory distress syndrome (RDS). Methods The databases of PubMed, EMBASE, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang Database, Weipu Database and China Biology Medicine disc (CBM) were searched, and all of the randomized controlled trial of LISA combined with CPAP for treatment of RDS were included. RevMan 5.2 was used to perform meta-analysis. The differences of mortality, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and other complications between LISA group and control group were compared in <34 weeks gestational age preterm infants with RDS. Results Five randomized controlled trials were included with 759 infants in total. Compared with control group, the rate of mechanical ventilation (RR: 0.32,95% CI: 0.13-0.82) and the incidence of BPD (RR: 0.61,95%CI: 0.42-0.88) were significantly decreased in LISA group. There were no differences in mortality and the incidences of ROP, IVH, and PVL between two groups (P>0.05). Conclusion The mechanical ventilation and the incidence of BPD is significantly reduced in the treatment of neonatal respiratory distress syndrome by LISA, but it has no effect on the incidences of other complications and mortality.

Objective To analyze the MRI features of central neurocytoma (CNC),and to improve the diagnostic accuracy of this lesion.Methods The MRI findings of 12 patients with CNC confirmed by surgery and pathology were evaluated retrospectively.All patients underwent contrast-enhanced and uncontrast-enhanced MR scan,and 3 patients also received plain CT scan.Results The lesions of 12 cases were all located in the lateral ventricles of septum pellucidum,which were close to the Monro's foramen.5 lesions located in the right lateral ventricle,5 lesions located in both lateral ventricles with 1 case reached the third ventricle,2 lesions located in the left lateral ventricle with 1 case reached the third ventricle.The mean diameter of the CNC lesions was 4.8 cm (ranged from 2.2 to 7.8 cm).11cases (92％) had vavious degrees of cystic change,8 cases (66.7％) had a spongy or soap bubble appearance and 1 case(8.3％) had completely cystic change.3 cases (25％) had a scalloping appearance on sagittal T1-weighted MRI.The solid part of the tumor was similar to the gray matter in signal intensity,with slightly high signal intensity on T2FLAIR.Among 9 cases with DWI,7 cases showed high signal intensity,1 case showed equal signal intensity,and 1 case showed slightly low signal intensity.On enhanced MRI,the solid part of tumors showed slight to medium (83％) or obvious (17％) enhancement.Conclusion CNC should be first considered when a young adult has a lesion located in the lateral ventricles of septum pellucidum,accompainied by varying degrees of cysts,showed slight to medium enhancement in the solid part of the tumor.

Objective To systematically assess the relation between angiotensin-I converting enzyme(ACE) gene insertion/deletion (I/D) variation and type 2 diabetic nephropathy (T2DN) onset risk among Chinese population.Methods The related literatures were retrieved from the China National Knowledge Infrastructure (CNKI) and Wanfang Data until June 1st,2016.The RevMan 5.0 was used to conduct the statistical analysis.The merge OR value and corresponding 95% confidence interval(95%CI) were used to assess ACE gene I/D polymorphism and T2DN onset risk.Results Totally 29 papers with 4 357 subjects were included according to the inclusion and exclusion standard,including 2 208 cases of DN and 2 149 cases of T2DM without DN.Meta analysis showed that compared with ACE gene I/D polymorphism I allele,D allele could significantly increase the risk of T2DM patients suffering from DN,the OR value and corresponding 95%CI were 1.44(1.25,1.66);the gene analysis showed that ACE gene I/D polymorphism loci were significantly correlated with DN onset risk in the Asian population.The corresponding relative onset risk OR and 95%CI were 1.42(1.15,1.76) and 1.75(1.46,2.10) in the dominant and recessive genetic model.The Begg′s test showed that the included data had no obvious publication bias existence.Conclusion ACE gene I/D polymorphism is closely correlated with the onset risk of T2DN,and D allele might be a risk genetic factor for DN occurrence in the patients with T2DM.

Objective To evaluate the health-related quality of life (HRQOL) and its influencing factors in pa tients with cervical cancer.Methods 120 inpatients with cervical cancer at Yunnan Tumor Hospital were investigated by functional assessment of cancer therapy-cervix (FACT-Cx),t-test,analysis of variance and multiple linear regression were used to analyze factors influencing the HRQOL.Results The total HRQOL score of patients was (104.88 ± 19.51),and the domain scores of physical well-being (PWB),social/family well-being (SWB),emotional well-being (EWB),functional well-being (FWB),cervical cancer subscale (CxS) were (20.41 ± 5.46),(17.17 ± 6.10),(15.73 ± 5.06),(13.34 ±5.83),(38.23 ±6.26),respectively.Based on multiple linear regression,the influencing factors of PWB were marital status and clinical stages,the influencing factor of SWB was marital status,the influencing factors of EWB were education levels and clinical stages,the influencing factors of FWB,CxS and total score were all marital status,clinical stages and education levels.Conclusions The HRQOL scores were influenced by a number of factors and it is significant to improve HRQOL in patients with cervical cancer by relieving symptoms and reducing treatment side effects according to patients' specialty,also psychological support and encouragement was essential.

Objective To improve the safety of surgery,the application of indocyanine green fluorescein(ICG)angiography in intracranial aneurysm surgery was investigated.Methods Fifty cases of intracranial aneurysms were retrospectively analyzed.All the patients were received ICG angiography before and after intracranial aneurysm clipping.The efficiency of the surgery was evalu-ated with CT angiography(CTA)and(or)digital subtraction angiography(DSA).The postoperative follow-up was conducted using Glasow outcomes score(GOS).Results Of the 50 patients,3 cases of aneurysmal neck remnant,one case of parent arteries steno-sis,one case of nearby branch stenosis and two cases of “false-negative”were observed after ICG angiography.The clips were adjus-ted until the satisfactory blood flew was restored.Postoperative CTA and(or)DSA confirmed the results of intraoperative ICG an-giography.Of the 40 patients underwent follow-up,GOS score was 5 in 30 cases,4 in 7 case,3 in 2 case and 2 in 1 case.Conclusion ICG angiography is a useful way to assess the clipping of aneurysms,blood flew of parent arteries and nearby branches during the aneurysm surgery.It could raise the safety of surgery and further improve the clinical outcomes of intracranial aneurysms.

Objective To explore the relationship between the expression of XRCC1 and glioma. Methods Total of 26 samples of glioma were divided into 4 groups:gradeⅠ,gradeⅡ,gradeⅢand gradeⅣ. The expression of XRCC1 in 26 Gliomas tissues were examined using SP immunohistochemical staining.Results The positive staining of XRCC1 protein was localized in nucleus of tumor cells in Glioma. There was no correlation among them. The difference of XRCC1 expression among gradeⅠ~Ⅳ was not significant ( >0.05) .Conclusion The difference of XRCC1 expression among gradeⅠ~Ⅳ was not significant. The expression of XRCC1 was closely correlated with the effect of radiotherapy.

Objective To investigate the molecular mechanism of retinoic acid in targeted treatment of craniopharyngioma by detecting the expression of RARαand PPARβ/δin craniopharyngioma cells and analyzing the correlation between the expression and effect of retinoic acid. Methods The expression of RARα and PPARβ/δ in craniopharyngioma cells from 31 patients cultured in vitro was quantified by reverse transcription-PCR. The inhibition rates of RA on craniopharyngioma with different expression of RARα and PPARβ/δ were detected by using MTT assay, and the correlation between the expression of RARα and PPARβ/δand the effect of RA was analyzed. Results 1. The RT-PCR results showed that the expression levels of PPARβ/δand RARα mRNA were different. Craniopharyngioma cells from 31 patients in primary culture were divided into three groups according the expression levels of nuclear receptor: PPARβ/δ>RARα group, RARα>PPARβ/δ group and RARα>>PPARβ/δ group. 2.MTT results showed that the inhibition rate of RARα>>PPARβ/δgroup was significantly higher than the other groups under same drug, the differences had statistical significance ( <0.01) . Conclusions The expression of PPARβ/δ, RARα can be used to evaluate the effect of RA in treatment of craniopharyngioma. The craniopharyngioma with low-expression of PPARβ/δ is more sensitive to RA. Targeting higher RARα or targeting lower PPARβ/δ is beneficial to the treatment of craniopharyngiomas.