Objective To discuss the factors which affect the postoperative functions of the ankle joint. Methods A retrospective study was done of 102 patients who had been diagnosed as malleolar fracture and operated on in our institute between January 2005 and January 2008. We recorded their age, gender, body mass index(BMI), fracture type (AO type), time from injury to operation and presence or ab-sence of cast immobilization. Their ankle functions were evaluated by X-ray and the Baird-Jackson evaluation system in regular follow-up. Relationship between the above-mentioned factors and the postoperative functions of the ankle joint was statistically analyzed, using univariate logistic regression and multiple stepwise logistic regression. Results A total of 102 patients were followed up for 24.7 (11 to 43) months. A negative correlation between the age, fracture type, reduction and postoperative function was found. The gender, body mass index (BMI), time from injury to operation and presence or absence of east immobilization, however, had no association with the postoperative function. The conservative treatment of the deltoid ligament injury complicated with the lateral malleolar fracture and/or improper treatment of the syndesmotic injury led to poor function. Conclusions The older a patient and the more serious a fracture, as well as the more unsat-isfactory the reduction, the poorer the postoperative ankle functions may be. To some extent, rational treat-ment of the deltoid ligament injury complicated with the lateral malleolar fracture and the syndesmotic injury may also determine the postoperative function of the ankle joint.

Objective To investigate the dynamic changes of claudin-5 expression around hematoma of intracerebral hemorrhage (ICH) in experimental rats and its correlation with cerebral edema.Methods 108 adult male SD rats were randomly divided into 6 groups:sham operation,6 h,12 h,24 h,3 d,7 d after operation groups respectively.The experimental ICH model was established by injecting autologous arterial blood into the caudate nucleus.Immunohistochemistry straining was used to detect the changes of expression of claudin-5 around hematoma at different time point after ICH.The permeability of blood-brain barrier (BBB) was tested by Evans blue method.The changes of brain water content were measured by the wet and dry weight method.Alexis method was used to examine the changes in neurological deficit scores.Results The expression of claudin-5 around hematoma was decreased gradually from 6 h after ICH,and it declined quickly at 12 h to 3 d after ICH.The expression of claudin 5 around hematoma was slightly lower at 7 d after ICH than in sham operation group.Permeability of the BBB was higher at 12 h to 3 d after ICH than any other groups,and reduced at 7 d after ICH.Brain water content was increased from 6h,the severest water content was at 12 h to 3 d after ICH,and it decreased gradually at 7 d after ICH.The neurologic impairment appeared from 6 h after ICH,the time point of severest neurologic impairment was at 12 h to 3 d after ICH,and it reduced from 7 d after ICH.The expression of claudin-5 around hematoma after ICH was negatively correlated with the permeability of BBB,brain water content and neurological deficit scores (r=-0.63,-0.71,0.59,all P＜0.05).Conclusions Claudin-5 expression plays an important role in the course of hemorrhagic cerebral edema and injury.It probably would he an effective way to alleviate the degree of hemorrhagic cerebral edema and injury after ICH by actively increasing the expression of claudin-5 at the early period of ICH.

Objective Molecular targeted drugs have anti-angiogenesis and anti-tumor effects.The study was to investigate the role of sunitinib on treating metastatic renal cell carcinoma ( mRCC) and its long-term efficacy and adverse reactions. Methods From November 2007 to March 2013, 281 mRCC patients were divided into two groups according to their own willingness.102 patients in the experimental group received sunitinib 50 mg per day.Pain score, metastatic focuses before and after targeted therapies were compared.179 patients in control group was treated by immunotherapy.Kaplan-Meier survival analysis was used to draw the survival curves and Cox regression model was applied in multivariate analysis. Results There was no difference between the two groups on baseline (P>0.05).In the experimental group, 78 cases were clear cell carcinoma, with remission rate 29.4%, stablity rate 53.8%and total effective rate 83.2%after treatment;15 cases were papillary renal cell carcinoma, with remission rate 33.3%, stablity ratio 46.7%and total effective rate 80.0% after treatment;9 cases were collecting duct carcinoma, with the remission rate 22.2%, the stablity ratio 55.6% and the total effective rate 77.8% after treatment.The bone scan after 1 cycle of treatment showed 2 cases progressed(10.5%), 5 cases relieved(26.3%) and 12 cases sta-blized(63.2%), the total effective rate of bone metastasis amounting to 89.5%, the effective rate of lung metastasis 81.7%, the effective rate of liver metastasis 60.0%and the effective rate of lymph node metastasis 72.8%.The median overall survival in the experimental group was 28.9 months, 20.7 months in control group(P<0.05).Cox regression analysis showed age, tumor classification, liver, lung, bone and lymph node metastasis were prognostic factors influencing mRCC.The common averse events were white blood cells, thrombocytopenia, neutropenia and hypoalbuminemia. Conclusion Sunitinib for the treatment of mRCC can diminish the metastatic focuses , ease the pain , improve the quality of life, delay the progression of the disease, and prolong the overall survival.

This study was aimed to investigate the effect of modifiedYin-Chen-Hao (YCH) decoction on the expression of aquaporin-8 (AQP8) mRNA and protein in rats with estrogen-induced cholestasis, in order to explore the potential mechanism of YCH decoction in the treatment of intrahepatic cholestasis during pregnancy. A total of 50 SD female rats, which were weighed between 180 g to 200 g, were randomly divided into the normal group (N,n = 10) and the model group (M’,n = 40). The animal model of intrahepatic cholestasis was induced by subcutaneous injection of 17-α-ethinylestradiol (5 mg·kg-1·d-1) for 5 days of rats in M’ group. The same volume of propylene glycol was subcutaneously injected to rats in N group. Five days later, rats in M’ group were divided into the model group (M,n = 10), high-dose (Zg,n = 10), middle-dose (Zz,n = 10) and low-dose (Zd,n = 10) modified YCH decoction group. The intragastric administration of normal saline, high-dose, middle-dose and low-dose modified YCH decoction were given to each group for 7 days, respectively. Then, rats were sacrificed and the liver tissues were removed and stored in liquid nitrogen. The expression of AQP8 mRNA and protein were detected by real-time polymerase chain reaction (RT-PCR) and western blotting analysis. The results showed that compared with the normal group (N), the expression of AQP8 mRNA and protein in liver tissues of rats in the model group (M) were decreased (P < 0.01). Compared with the model group (M), the high-dose, middle-dose and low-dose modified YCH decoction can increase the expression of AQP8 mRNA and protein in liver tissues (P < 0.05). Moreover, along with the dose increasing of modified YCH decoction, the upregulation of AQP8 mRNA and protein was increased. It was concluded that the molecular mechanism of modified YCH decoction in treatment of intrahepatic cholestasis during pregnancy may be through the increasing of AQP8 mRNA and protein in liver tissues.

A total of 210 female patients with overactive bladder (OAB) were divided into M receptor blockage (M,n =71),pelvic floor muscle stimulation physiotherapy (S,n =70) and combination (C,n =69) groups.After one course of treatment,the OAB symptom scores were compared to pretreatment values (P ＜ 0.05).After a second course,the overall response rate was 69％ in group S.Pelvic floor muscle stimulation physiotherapy provided excellent sustained outcomes.

Objective To investigate caspase 3 in the apoptosis of EJ cells in bladder carcinoma induced by mitomycin C(MMC). Methods The apoptosis and changes in cell cycle were examined by means of TUNEL and flow cytometry. The ability of caspase 3 antibody to resist apoptosis induced by a low dose of mitomycin was also studied. Results The typical characteristics of apoptosis were observed in EJ cells treated with low dose of mitomycin and the apoptotic index (AI) was (62.9? 2.2 )%, being much higher than that in the group treated combinedly with caspase 3 antibody and MMC(4.9?0.3)% and in the controls (2.7?0.7)%, P

Adult ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Rhinoplasty ; methods ; Treatment Outcome ; Young Adult

Objective To compare the risk factor of chilldren with autism and ordinary children during perinatal period. Methods One hundred and fourty children with autism and 82 ordinary children were reviewed by self-written general circumstance questionnaire and risk factor questionnaire. Results Viral influenza during pregnancy (x2 =15.29) ,bom suffocate( x2 =6. 04) , premature delivery (x2 =6. 48) , dystocia (x2 =2. 83) and artificial feeding ( x2 = 6. 02 ) were risk factors for children autism (P < 0. 05 ). Conclusion Childeren autism is associated with risk factors in rinatal period. Early dectecion and early prevention and treatment may improve the outcome.

Objective To evaluate the relationship between the anxiety condition and educational background of the autistic children's parents. Methods Questionnaires for the self-evaluation of anxiety were collected from the parents of 140 children with autism. Results The autistic children's mothers had significantly higher score of anxiety than the fathers (42. 73 ±8. 25) (t =6. 783,P ＜0. 05). The autistic boy's parents had significantly higher anxiety pressure than autistic girl's parents ( 51.38 ± 11.24 vs. 43.23 ± 6. 12) ( t = 4. 894,P ＜0. 05). The anxiety intensity of the autistic children's parents was negatively correlated with the parents'educational background ( F = 10. 788, P ＜ 0. 05 ). Conclusion The autistic children' s parents had certain anxiety,which is correlated with the their educational background and genders of the autistic children. It is necessary to interfere the negative mood to facilitate the treatment of the autistic children.

Objective: To systematically evaluate risk factors for cardiometabolic multimorbidity (CMM), so as to provide the evidence for formulating CMM prevention and control strategies. Methods: Publications pertaining to the risk factors for CMM were retrieved from databases, including SinoMed, CNKI, Wanfang Data, VIP, PubMed and Cochrane Library from inception to March 31, 2023. Meta-analysis was performed using the software RevMan 5.4 and Stata 16.0, and sensitivity analysis was performed using the leave-one-out method. The publication bias was evaluated using Egger's test. Results: Totally 494 publications were screened, and 20 publications were included in the final analysis, including 13 cohort studies (covering 1 940 000 participants) and 7 cross-sectional studies (covering 13 000 000 participants). Meta-analysis revealed that female (OR=1.54, 95%CI: 1.40-1.71), middle age (OR=3.80, 95%CI: 3.33-4.34), elderly (OR=2.82, 95%CI: 1.48-5.37), urban resident (OR=1.41, 95%CI: 1.27-1.57), higher education level (OR=2.01, 95%CI: 1.35-3.01), higher economic level (OR=1.21, 95%CI: 1.16-1.25), overweight (OR=1.92, 95%CI: 1.64-2.26), obesity (OR=3.01, 95%CI: 2.30-3.93), central obesity (OR=1.70, 95%CI: 1.12-2.56), smoking (OR=1.27, 95%CI: 1.07-1.51), alcohol consumption (OR=1.27, 95%CI: 1.01-1.59), irregular diet (OR=1.10, 95%CI: 1.02-1.18), insufficient intake of vegetables and fruits (OR=1.12, 95%CI: 1.07-1.17), lack of sleep at night (OR=1.17, 95%CI: 1.08-1.27), and depression (OR=1.50, 95%CI: 1.33-1.69) were risk factors for CMM. Sensitivity analysis of effects of central obesity and alcohol consumption were not robust. No publication bias was examined by Egger's test. Conclusions Female, middle age, elderly, urban resident, higher education level, higher economic level, overweight, obesity, central obesity, smoking, alcohol consumption, irregular diet, insufficient intake of vegetables and fruits, lack of sleep at night and depression are risk factors for CMM.