Objective To evaluate the clinical effect of limited open reduction, poking reduction and QWIX cannulated screw internal fixation in treatment of posterior malleolar fracture. Methods A total of 14 patients with posterior malleolar fracture were treated by limited open reduction, poking reduction and QWIX cannulated screw internal fixation. Injury causes included traffic accidents in five patients, fall from height injury in four and inversion sprain in five. According to fracture type classification methods of Weber and Danis, there were two patients with type A3, seven with type B3 and five with type C3. Func-tional exercise was carried out based on postoperative exercise plan. Regular follow-up was performed to e-valuate the functional recovery of the ankle joint. Results All patients were followed up for 6-18 months (average 9.5 months). One patient with sural nerve injury returned to normal after six months. Twelve pa-tients showed excellent range of motion of the ankle joint and normal gait three months after operation. In 12 patients, dorsiflexion of the ankle joint was > 20° and plantar flexion > 40° six months after operation, which was approximately similar to contralateral normal ankle joint. The ankle joint function of all patients returned to normal six months after operation. According to Baird-Jackson ankle joint function evaluation, the result was excellent in 12 patients, good in one and fair in one, with excellence rate of 93%. Con-clusion The limited open reduction, poking reduction and internal fixation of QWIX caunulated screw are effective method for treatment of posterior malleolar fractures.

In this study,we isolated and characterized chlorobenzene degrading bacteria from the effluent and sludge samples of one chemical plant.Minimal medium supplemented with chlorobenzene as sole car-bon source was used during the enrichment and domestication process.Seven major bacterial isolates were obtained and purified.Their 16S rRNA genes were amplified by PCR for sequencing and their identities were determined with homology comparisons.Five of the seven isolates belong to Actinomycetales in-cluding Kocuria KD139,Rhodococcus KD140,Rhodococcus KD142,Arthrobacter KD230,and Ar-throbacter KD232;one is classified as Bacillus d KD178;and another one as Stenotrophomonas KD237.The phylogenetic tree was also constructed based on the analysis of 16S rRNA gene sequences.Chloro-benzene concentrations were quantified with gas chromatography to investigate the bio-degradation rates of the isolated strains.Stenotrophomonas KD237 degraded 60.78% chlorobenzene in the minimal medium within 24 h.

Objective To investigate the effect of intralesional lauromacrogol therapy on infantile hemangioma.Methods 30 cases all received intralesional injection of lauromacrogol.The changes of tumor size,texture and color were monitored and recorded.The adverse effects after medication were observed and managed accordingly.The adverse effects after medication were observed.The times of treatment were determined according to degree of reduction of tumor volume.To assess the efficacy,a 4 scales system was adopted.Results All patients had completed the treatment and followup.The overall response was scale Ⅰ in 2 cases (6.7 ％),scale Ⅱ efficacy in 4 patients (13.3 ％),scale Ⅲ efficacy in 5 cases (16.7 ％) and scale Ⅳ in 19 cases (63.3 ％).The smaller the tumor,the fewer the times of treatment,and the better the results.The effects of treatment were better if patient could be treated by intralesional lauromacrogol therapy in early stage.No severe adverse effects were observed during 6 months of follow-up.Conclusions Intralesional injection of lauromacrogol sclerotherapy is a safe and effective way to treat infantile hemangioma.

Critical Illness ; Humans ; Pancreatitis, Acute Necrotizing ; diagnosis ; surgery ; therapy

Objective To observe the effects of progesterone on the mRNA and protein expressions of nerve growth factor(NGF) and brain-derived neurotrophic factor(BDNF) in the focal cerebral ischemia-reperfused rats,and to explore its mechanism of brain protection. Methods Totally 96 healthy male SD rats were randomly divided into sham surgery group,ischemic reperfusion group,vehicle-treated group and progesterone-treated group (n=24 for each).The model of focal brain ischemia-reperfusion injury was induced by middle cerebral artery occlusion (MCAO).After 2 h temporary MCAO,rats were subjected to reperfusion for 3 h,6 h,12 h and 24 h,respectively.The mRNA and protein expressions of NGF and BDNF were analyzed by real time-PCR and Western blot,respectively. Results In the injured cortex,the mRNA and protein expressions of NGF and BDNF in ischemic reperfusion group came to the peak at 6 h after reperfusion,and then gradually declined to the level of sham operation group at 24 h after reperfusion.In progesterone treatment group,BDNF and NGF mRNA and protein expressions reach the peak at 12 h after reperfusion,and were still higher at 24 h after reperfusion than in ischemic reperfusion group(P＜0.05). Conclusions Progesterone plays a protective role in focal cerebral ischemia-reperfusion by increasing the expressions of BDNF and NGF in rats.

Objective To evaluate the value of united nerve electrophysiological tests in the diagnosis of diabetic peripheral neuropathy (DNP).Methods The quantitative temperature threshold (QTT), including the cold sensation threshold (CST) , thermal sensation threshold (WST), cold pain threshold (CPT) and thermal pain threshold (HPT), sympathetic skin response (SSR) and nerve conduction velocity (NCV) were measured for 85 diabetic patients.Results The abnormal rate of QTT was 84.71％ , significantly higher than that of SSR and NCV (56.47％ and 31.76％ respectively).However, no significant difference was found in the abnormal rate of QTT between the DPN asymptomatic group and DPN symptomatic group (78.85％ and 93.94％ respectively).There was significant difference in the abnormal rate of SSR (48.08％ and 69.70％ respectively) and the abnormal rate of NCV (19.23％ and 51.52％ respectively) between the above two groups(P ＜ 0.05).There was no difference in the abnormal rate of QTT for patients with short or long course of disease (77.77％ and 89.80％ respectively), but significant difference in the abnormal rate of SSR (44.44％ and 65.31％ respectively) and the abnormal rate of NCV (19.44％ and 40.82％ respectively) Conclusion The abnormal rate of QTT was highest in detecting the diabetic patients, and it is not related to clinical symptoms or disease course.However, the abnormal rates of SSR and NCV were related to clinical symptoms and course.It is more sensitive to diagnose DPN using united electrophysiological tests of QTT, SSR and NCV.

Objective To investigate the roles of CpG motifs in the release of cytokines induced by bacterial DNA. Methods Mice were sensitized with injection of D GalN (600 mg/kg) into the abdominal cavity 1 h before experiment. Mortality was observed after purified Escherichia coli DNA(EC DNA), calf thymus DNA(CT DNA), phosphorothioate backbone CpG oligodeoxy nucleotides (CpG ODN) and CG sequence inverted oligodeoxy nucleotides (non CpG ODN) were injected venously into mice. The injection dosage of DNA given was 30 mg/kg but ODN was 10 nmol/mouse. THP 1 cell lines were cultured in vitro . After the above reagents were added into the culture, TNF ?, IL 6, IL 1? levels were detected to observe the different abilities of these reagents to induce the release of cytokines. Results EC DNA and CpG ODN could induce the death of mice and the large amount of release of cytokines, but CT DNA and Non CpG ODN could not. Conclusion CpG ODN has the ability to induce macrophage to release cytokines largely. CpG motifs, which may play an important role in the release of cytokines induced by bacterial DNA, may probably be the structural basis of bacterial DNA.

Objective To analyze the results of postoperative conventional radiotherapy supplemen- ted by stereotactic radiotherapy for glioma and with analysis of prognostic factors.Methods From Dec. 1998 to Dee.2004,143 patients with brain glioma were postoperatively treated with conventional radiotherapy supplemented by stereotactic radiotherapy.Steretactic radiotherapy of 5-7 Gy/fraction,to totally 5-7 fractions were added as boost to the GTV following the conventional radiotherapy.The conventional radiotherapy,ai- ming at the peri-tumoral subclinical micro-loci,was about 50 Gy.Results The KPS grades were 81?9, 71?9 in patients 3-6 month after treatment in contrast to that prior to operation (t=5.98,P＜0.01 ).CR 39 patients (27.3%) ,PR 70 patients(49.0% ) ,NC 25 patients(17.5%),PD 9 patients(6.3%),with an effi- ciency rate of 76%.The 1-,3-,and 5-year survival rate was 56.6%,36.0% and 21.7%,respectively. Prognostic factor analysis showed that patients with low grade glioma had better survival time.Age,tumor site and dose,etc were unrelated to prognosis.Conclusion Stereotactic radiotherapy supplementing conven- tional radiotherapy is effective for postoperative brain glioma,which method not only shows excellence in physical dose distribution but strictly in accordance with the principle of radiobiology also.

Objective To observe the effect of cluster needling at scalp acupoints on cognitive function in Alzheimer disease (AD), and to elucidate its mechanism. Method Seventy eligible patients with cognitive impairment were randomized into two groups by their admission number. The treatment group was intervened by cluster needling at scalp acupoints plus oral administration of Fluoxetine hydrochloride, while the control group was by ordinary acupuncture. Two treatment courses later, the two groups were observed and compared in therapeutic efficacy and Activities of Daily living (ADL). Result There was a significant difference in comparing the total effective rate between the two groups (P＜0.05), the ADL scores dropped significantly in both groups after intervention (P＜0.01), and the decrease in the treatment group was statistically more significant (P＜0.01). Conclusion Cluster needling at scalp acupoints can effectively improve cognitive impairment in AD patients, and can promote the quality of life.