Objective To compare the result differences of different dynamic nerves transferring to different segments of the radial nerve. Methods From 1997 to 2000, different ways of intercostal nerves or contralataral C 7 transfering to different segments of the radial nerves were carried out in 36 cases with total avulsed brachial plexus injuries that were followed up for average 42.39 months. Four-fold table was selected to statistically calculate the effective rate of muscle strength recovery. Results The total effective rate was 56% (20/36). The effective rate of the functional rehabilitation of elbow extension was 5/8 in the group with neurotization to radial nerve trunk and 4/4 in the group with neurotization to branches innervating the triceps brachii muscle of radial nerve. The highest effective rate up to 75% (9/12) of the functional rehabilitation of wrist and digit extension belonged to the group with contralateral C 7 transferring to the radial nerve segment in the humeral spiral groove where branches innervating the triceps brachii muscle had already diverged. Conclusions The way of neurotization to radial nerve trunk and to branches innervating the triceps brachii muscle of the radial nerve can win good functional rehabilitation of elbow extension. Contralataral C 7 transfering to the radial nerve segment in the humeral spiral groove ranks the best way for function recovery of the wrist extension. Age below 30 years and operation interval less than 12 months are helpful for functional rehabilitation of the radial nerve.

Purpose:To discuss the function of Gd-BOPTA on the deferment of manifestation of MRI,which bring influence to the immune mensuration of antigen PCNA,PTEN.Materials and Methods:Scanning with MRI on the 35 patients with pathologically verified HCC the image were analyzed concretely.Pathologic diagnose was made with Edmondson pathologic classification standard,and it was expressed with index of PCNA and PTEN of immune quantitative analysis.Results: HCC was negatively related to the index of PCNA,and most patients with high index were lightly or not deferred enhanced(13/16),Patients with low index were evidently enhanced ( 10/19).The degree of HCC deferred enhancing was positively related to the expression of PTEN.Most HCCs( 15/17) with negative PTEN were lightly or not deferred enhanced,while positive patients of PTEN were mostly enhanced obviously(11/18).Conclusion: Deferment of Gd-BOPTA can be used to basically estimate the tincture of tumor biology,therefore,the enhanced degree of which,the PCNA,PTEN,can offer great help in choosing the therapuetic method and estimating the outcome of the the therapy.

BACKGROUND: Conventional means in treatment of distal tibiofibular syndesmosis disruption include plaster cast or splint immobilization as external fixation and internal fixation using screws, and bone bolts or plates;however, some disadvantages such as unstable fixation and uncertain fixation exist.OBJECTIVE: To observe the primary clinical curative effect of newly self-developed fixation, Hook-plate fixation (HPF), for distal tibiofibular syndesmosis disruption and its biochemical characteristics of HPF.DESIGN: Self-control observation.PARTICIPANTS: We recruited 23 patients with sustaining abruption of lower tibiofibular ligament union with fibular fracture who received treatment in the Department of Orthopedics, Affiliated Hospital of Yangzhou University Medical College, between October 2001 and March 2004. According to the Lauge-Hansen classification system, there were 11 cases of supination-lateral rotations, 7 cases of pronation-lateral rotations and 5cases of pronation-abductions. Among them 14 had bimalleolar fractures and 9 had trimalleolar fractures.METHODS: HPF was used on the 23 patients with distal tibiofibular syndesmosis disruption. Radiographs were taken routinely. Talocrural joint function exercise was recommended at week 1 and partial weight bearing was allowed 2 months later. Functions were evaluated according to modified Mazur's criteria (excellent, good, fair and poor).MAIN OUTCOME MEASURES: ①Healing time and function ev aluation after operation for distal tibiofibular syndesmosis disruption. ② Adverse events and side effectsRESULTS: Totally 23 patients entered the result analysis, with the mean of 11 months' follow-up. ①Results of healing time and function evaluation in the patients after operation for distal tibiofibular syndesmosis disruption: The healing time of fracture ranged from 12 to 18 weeks: 16 cases were excellent, 5 good, and 2 fair. ② Adverse events and side effects:There was no separation of the tibiofibular space, the distance between medial malleolus or lateral malleolus and anklebone was symmetrical.There was no mobilization or rupture of the internal fixation after operation.CONCLUSION: HPF is applied in treating distal tibiofibular syndesmosis disruption. It causes no postoperative complications, and can recover the ankle joint function with stable internal fixation and good biomechanical features.

Objective To compare the efficacy of insulin aspart and human soluble insulin on postprandial glucose control and blood glucose excursion in type 2 diabetic patients managed with insulin pump therapy. Methods All of 345 hospitalized type 2 diabetic patients were randomized divided into two groups. One group underwent insulin pump therapy with insulin aspart (aspart group, 173 cases),another group with human soluble insulin (humulin R group, 172 cases). Capillary glucose concentrations were measured at 9 time points,including preprandial,2 hours postprandial,bedtime (22:00),midnight(0:00) and 3:00 every day during the treatment. The change of blood glucose at each time point and the variation of postprandial blood glucose excursion was compared between the two groups. The frequency of hypoglycemia was also evaluated. Results After treatment, fasting blood glucose and post breakfast and post dinner blood glucose levels were decreased more significantly in the aspart group than those in the humulin R group. And a significantly smaller postprandial blood glucose excursion was shown in the aspart group compared with that in the humulin R group (P< 0.05). The time to achieve good glycemic control in the aspart group was (4.40 ± 2.16) d, significantly shorter than that in the humulin R group[(5.68 ± 2.29) d](P< 0.05). The incidence of hypoglycemia was significantly lower in the aspart group (P <0.05). Conclusion Insulin aspart results in better control of blood glucose and less glycemic variability compare with human soluble insulin in type 2 diabetic patients during delivery by continuous subcutaneous insulin infusion.

Objective To observe the influence of congenital heart disease(atrial septal defect,ASD)to intervene closure on the right structure of children(<1 5 years)and adults(1 5-65 years)and to make the safety assessment.Methods Totally 1 1 1 un-derwent interventional treatment of complications in patients with ASD in our hospital from 2010 to 2013 were retrospective ana-lyzed.Closure on changing of right heart structure of child and adult were measured by ultrasonic cardiogram.Closure falls off,shut valve insufficiency,arrhythmia,residual shunt were recorded by ultrasonic cardiogram and electrocardiogram.making statistical a-nalysis.Results The inner diameter of the right atrium(RAD),right ventricle diameter(RVD),pulmonary artery diameter(PA) and right ventricular outflow tract(RVOT)were decreased compared with pre-operation(P < 0.05 ),during the follow-up 1,3,6 month,they was continue decreased in the aged between1 5-65 group(P <0.05),but was stable in less than 1 5 years old age group (P >0.05 ).The complication rate of children and adults were 25.0% and 21.3% respectively,and there were no significantly difference(P >0.05),and was no serious complications.Conclusion Congenital heart disease intervention of atria septal defects can improve heart right structure,which can benefit both children and adult,there is no difference in complication rates.All of these have less serious complications,high safety,curative effect affirmation.

The osteogenic in vitro effect of low intensity pulsed ultrasound (LIPUS) on SD rat adipose-derived stem cells (ADSCs) was investigated. Rat ADSCs underwent LIPUS (intensity=100 mW/cm(2)) or sham exposure for 8 min per treatment once everyday in vitro, and then the alkaline phosphatase (ALP) activity and mineralized nodule formation were assessed to evaluate the osteogenic effect of LIPUS on ADSCs. To further explore the underlying mechanism, the osteogenic-related gene mRNA expression was determined by using reverse transcriptase-polymerase chain reaction (RT-PCR) at 1st, 3rd, 5th, 7th day after exposure repectively. Westen blot was used to evaluate the protein expression levels of two osteogenic differentiation associated genes at 7th and 14th day repectively. It was found that ALP activity was increased after LIPUS exposure and LIPUS resulted in mineralized nodule formation of ADSCs in vitro. LIPUS-treated ADSCs displayed higher mRNA expression levels of runt-related transcription factor 2 (Runx2), osteocalcin (OCN), ALP and bone sialoprotein (BSP) genes than controls, and the protein levels of Runx2 and BSP were also increased. The results suggested that LIPUS may induce the osteogenic differentiation of ADSCs in vitro.

In order to study the resistance of Neisseria (N.) gonorrhoeae to the fluoroquinolone and detect mutation patterns of quinolone resistance-determining regions (QRDRs) of clinical isolates in Shanghai,China,a total of 80 clinical isolates of N.gonorrhoeae were consecutively collected from Shanghai.The MIC of fluoroquinolone for the isolates was examined by using the agar dilution method and the mutation profiles of the QRDRs of gyrA and parC were analyzed by sequencing and restriction fragment length polymorphism (RFLP).Chi-square test was used for comparison of the mutation patterns.The results showed that:(1) High percentages of the 8 isolates were resistant to ciprofloxacin (95.0%),ofloxacin (95.0%) and lomefloxacin (97.5%),only one strain was susceptible to the ciprofloxacin.(2) Sensitive strains had a substitute of Asp95→Ala in the gyrA,and all isolates that were resistant or intermediated to the ciprofloxacin,had a double mutation in the gyrA (Set91,Ala 92 and Asp95).Some strains also had a mutation in the parC.(3) The MICs of these isolates were significantly associated with the mutation patterns in the gyrA and parC.A double mutation of gyrA combined with parC87 mutation was a predominant pattern in Shanghai and could mediate high level resistance to ciprofloxacin.It suggests that mutations in the QRDRs of gyrA and parC .may be re-sponsible for the fluoroquinolone resistance.And fluoroquinolone could not be used as the first line antibiotics for gonorrhea treatment any more in Shanghai,China.

Objective To investigate the degradation of dicalcium phosphate dehydrate-coated Mg-Zn alloy in vivo and bone formation. Methods Left femoral condyles were drilled in 72 New Zealand rabbits, and were randomly divided into experiment group (n＝24, implanted with dicalcium phosphate dehydrate-coated Mg-Zn alloy rods), Mg-Zn alloy control group (n＝24, implanted with Mg-Zn alloy rods) and poly-L-lactide acid rod group (n＝24, implanted with poly-L-lactide acid rods). Serum concentrations of Mg~(2+) were examined 1 d pre-operation, and 1 d, 1 week, 2 weeks, 5 weeks and 10 weeks post-operation in experiment group and Mg-Zn alloy control group. Operation sites were examined by X-rays at 3, 6, 12 and 18 weeks post-operation. After X-ray examination at each time point, 6 rabbits in each group were sacrificed, and subjected to histopathological observation of live and kidney tissues by HE staining. Tissues from condyles of femur were observed by HE staining and 2, 4, 6-trinitrophenol rosein staining, and mineral apposition rate of bone was calculated. Results There was no significant difference in the concentrations of serum Mg~(2+) at each time point between Mg-Zn alloy control group and experiment group (P>0.05). X-ray examination revealed gas emerged near the implants 3 weeks after surgery in Mg-Zn alloy control group. However, there was no obvious histological abnormality in liver and kidney tissues. The mineral apposition rate was higher and the degradation of material was lower in experiment group than those in the other two groups. Conclusion Dicalcium phosphate dehydrate-coated Mg-Zn alloy has a favourable biocompatibility, and degrades more slowly in vivo.

Objective To investigate the changes of serum N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration in patients with Graves' disease (GD) and its clinical significance. Methods Two hundred and sixty-nine patients with GD were enrolled in this study. Serum concentrations of thyroid hormones,TRAb, and NT-proBNP were measured. Results Serum NT-proBNP levels were positively associated with FT3(r=0.260, P<0.01), FT4(r=0.297,P<0.01) and heart rate (r=0.251, P<0.05) independent of age,sex and body mass index (BMI). The difference of serum NT-proBNP concentrations between newly-onset and treated patients existed (P<0.01) after the adjustment for thyroid hormone levels, age, sex and BMI. Serum FT4level exerted a significant impact on NT-proBNP level (P <0.01). Serum NT-proBNP increased even in patients with controlled thyroid function. Conclusion Serum NT-proBNP level in patients with GD increases with elevation of FT4 independent of sex, age and BMI. The measurement of serum NT-proBNP concentration appears to be helpful to monitor the alteration of vascular stiffness and fluid volume in GD patients, and may provide useful evidence for early intervention of cardiovascular disease induced by hyperthyroidism.

Background To explore the relationship between polymorphism of APOE gene in traumatic brain injury(TBI)patients suffering from traffic accident and the outcome of TBI.Methods TBI patients were randomly selected in this study with caxe-wntrol trial. The genotype of APOE allele was tested by a polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP), and the association between different genotypes of APOE alleles and outcome of TBI patients, were analyed.Results In TBI group frequency of APOE ε2 allele was 0. 1010, and frequency of APOE ε2/ε3 was 0. 1596.Both of these results were significantly higher than that in normal people (APOE epsilon 2 was 0. 0050, APOE ε2/ε3 was 0. 0100) (P＜0.05). Frequency of APOE ε2 and APOE ε2/ε3 in TBI group who died was 0. 1970 and 0. 2727. These were significantly high compared to TBI patients who had good recovery.Conclusions APOE allele ε2 and APOE genotype ε2/ε3alleles indicate a poor prognosis of traumatic brain injury patients.