BACKGROUND: Magnetic navigation META nailing for tibial fractures via the supra-patellar approach is a novel surgical method, exhibiting overt advantages.OBJECTIVE: To retrospectively analyze the clinical characters of magnetic navigation META nailing via the supra-patellar approach for tibial fractures.METHODS: Clinical data of 58 cases of tibial shaft fracture were collected and analyzed retrospectively, and all patients were treated with navigation META-NAIL via the supra-patellar approach. The patients received the postoperative prophylactic antibacterial therapy; non-weight bearing functional training was performed at 3 days postoperatively, and full weight-bearing functional exercise was conducted at an average of 12 weeks postoperatively.RESULTS AND CONCLUSION: (1) The Lysholm scores ranged from 83 to 95 (average, 90) at 24 weeks postoperatively. (2) The excellent and good rate evaluated by Johner-Wruh scoring reached up to 95％. (3) The average operation time was 65 minutes, and the blood loss was 30 mL. (4) There was no complaint of knee pain during the follow-up. (5) No postoperative complications, such as non-healing wounds, infection, bone nonunion, osteomyelitis or deformity recovery, occurred.(6) These results manifest that the magnetic navigation META-NAIL for tibial shaft fractures via the supra-patellar approach exerts a lot of advantages, including short operation time, accurate reduction and stable fixation. Most importantly, it can avoid cut patellar tendon tissue, and reduce the rate of knee pain, further promoting early functional exercise, which obtains satisfactory treatment outcomes.

Objective: To analyze the relationship between meteorological factors and the number of daily heart failure (HF) patients for emergency room (ER) visit at Fengxian district of Shanghai in order to provide the experience for prevention and control of HF morbidity. Methods: Daily number of HF patients treated in ER of our hospital from 2012-01 to 2014-12 with corresponding meteorological, air pollution data at the same period were collected and analyzed by Spearman correlation study and multiple stepwise regression analysis. Results:①The differences of temperature, humidity, air pressure at 24-, 48-hour before and 48-hour after ER visit were positively related to the number of HF patients; the number of HF patients was signiifcantly related to the differences of temperature and air pressure at 48-hour before ER visit,P<0.001.②Multiple stepwise regression analysis showed that the most affecting meteorological factor for ER visit of HF patients was the daily lowest temperature,P<0.05, the second factor was the daily average relative humidity,P<0.05. Conclusion: Radical changes of temperature, relative humidity and air pressure elevated the number of HF patients for ER visit; daily lowest temperature and decreased relative humidity were the important factors for elevating the number of HF patients for ER visit.

Objective To investigate the fatigue properties of bone cement specimens prepared with different monomer storing temperatures and polymerization environment temperatures; to find out the combination of the storing temperature of bone cement monomer and the mixing temperature of bone cement. Methods Bone cement monomer was stored under 21 ℃ or 4 ℃ environment. They were mixed with the powder under partial vacuum at room temperature of 21 ℃ for 1 minute, followed by 3 minutes' rest. The cement was then injected into metal molds with different temperatures of 21 ℃ or 50 ℃. Finally, the polymerized cement specimens were removed from the molds for mechanical tests. The bone cement specimens were divided into four groups. Group 1(control group): monomer temperature 21 ℃, metal mold temperature 21 ℃. Group 2: monomer 21 ℃, mold 50 ℃. Group 3: monomer 4 ℃, mold 21 ℃. Group 4: monomer 4 ℃, mold 50 ℃. Each group consisted of 21 specimens. All specimens were soaked in 37 ℃ water bath, and were tested with MTS mechanical test machine. Completely reversed tension-compression cycling loading was applied. Testing strength exerted was 15 MPa and the frequency was 2 Hz. This strength was approximately 3.5 times of the force that cement received in vivo. The cycles to failure was recorded. Specimens that failed in less than 5000 cycles were excluded. Comparisons of cycles to failure among different groups were performed using independent sample t tests. Results The cycles to failure of the control group(group 1) were lower compared with those of group 2, 3 and 4. The differences were all statistically significant(P≤0.001). Conclusion 1) The combination of monomer temperature of 21 ℃ and metal mold (polymerization environment) temperature of 21 ℃ produced the worst bone cement specimens in terms of their fatigue property. 2) The fatigue property was obviously improved when the monomer and the mold temperatures differed by 20 ℃ to 30 ℃.

Objective The extremely xerothermic environment of desert easily causes heatstroke and consequently multiple organ damage.Few reports are seen at home and abroad on heatstroke-induced lung injury associated with dry heat of desert.This stud-y explored the changes of the injured lungs in heatstroke rats in xerothermic desert. Methods Forty-eight male SD rats were ran-domly divided into six groups of equal number: mild, moderate and severe heatstroke groups and their corresponding controls.The rats of the three heatstroke groups were exposed to a temperature of 41 ℃and humidity of 10%, while those in the three corresponding control groups to a temperature of 25 ℃ and humidity of 35% for 70, 110 and 145 minutes, respectively.Then all the rats were sacrificed and the bronchoalveolar lavage fluid ( BALF) and lung tissues were collected for observation of pathological changes, obtainment of lung in-jury scores, calculation of the wet/dry weight ratio of the lungs, measurement of the total protein level in the BALF, and determination of the malondialdehyde ( MDA) content in the lung tissue. Results The mild, moderate and severe heatstroke groups showed re-markable increases compared with the three corresponding control groups in lung injury scores (3.25 ±0.50, 6.50 ±0.58 and 8 ± 0.82 vs 1.25 ±0.50, 1.00 ±0.00 and 1.25 ±0.50), the wet/dry weight ratio of the lungs (3.50 ±0.57, 4.85 ±0.19 and 4.10 ± 0.07 vs 1.78 ±0.66, 1.67 ±0.68 and 1.67 ±0.25), the total protein level in the BALF ([93.51 ±5.54], [141.24 ±6.07] and [160.76 ±6.74] μg/mL vs [42.6 ±8.67], [45.25 ±6.78] and [41.68 ±3.62] μg/mL), and the content of MDA in the lung tis-sue ([1.79 ±0.08], [2.79 ±0.11] and [3.52 ±0.36] nmol/mg prot vs [1.21 ±0.12], [1.20 ±0.12] and [1.28 ±0.19] nmol/mg prot) .The lung injury scores, the total protein level in the BALF, and the content of MDA in the lung tissue were increased with the prolonging of the time of exposure to dry heat, while the wet/dry weight ratio of the lungs was the highest in the moderate heat-stroke group.The lung injury scores were positively correlated with the wet/dry weight ratio of the lungs, the total protein level in the BALF, and the content of MDA in the lung tissue (P<0.01). Conclusion Heatstroke in the xerothermic environment of desert can cause lung injury in rats, which deteriorates with the prolonging of the time of exposure to dry heat.As for the management of such heatstroke, more attention should be paid to the protection against lung injury.

Objective To investigate the effect of rhodiola on severe acute pancreatitis associated renal injury and explore the potential mechanisms.Methods A total of 90 rats were randomly divided into sham-operated group (S group,n =18),severe acute pancreatitis with renal injury group (M group,n =18),low rhodiola dose group (3 g/kg,T1 group,n =18),moderate dose rhodiola group (6 g/kg,T2 group,n=18),high rhodiola dose group (9 g/kg,T3 group,n =18).The S and M groups were given 6 g/kg saline through intraperitoneal injection before operation while the T1 group,T2 group and T3 group were given with 3 g/kg,6 g/kg,9 g/kg dose of rhodiola through intraperitoneal injection,respectively.The pancreas was dissected and the head of pancreas was occluded by blood vessel forceps for 3 hours to make rat model.All the rats were sacrificed at 12 h,24 h,36 h after modeling.The level of ascites amylase,serum amylase,creatinine,blood urea nitrogen,interleukin 1β(IL-1β) and interleukin 10 (IL-10) were detected and the pathological change of pancreas and the left kidney was observed under light microscope.The serum levels of IL-1β and IL-10 were detected by enzyme-linked immunosorbert assay (ELISA).Take the right kidney for superoxide dismutase (SOD) determination and the expression of hypoxia inducible factor-1α (HIF-1α)mRNA in the right kidney was detected by real-time polymerase chain reaction (RT-PCR).Results Compared with the S group,the level of serum amylase,creatinine,blood urea nitrogen and IL-1β in M group increased significantly,but the activity of SOD has a significant decline (P ＜ 0.05).Compared with M group,the level of serum amylase,creatinine,blood urea nitrogen and IL-1 β in T2 group has a significant decline,but the activity of SOD,the express of HIF-1α mRNA and IL-10 has a significant increase (P ＜ 0.05).With the dose of rhodiola increased,the renal and pancreatic function in T2 group had a better performance than T1 group,and the difference was statistical significant (P ＜ 0.05).But compared with T2 group,the renal and pancreatic function in T3 group did not increased significantly (P ＞ 0.05).Conclusions Moderate dose of rhodiola (6 g/kg) has a good protective effect on severe acute pancreatitis associated renal injury.It may be associated with the inhibitory expression of IL-1β,up-regulated expression of IL-10,HIF-1α mRNA,and the increased activity of SOD.So it can then reduce cell apoptosis and renal necrosis,and improve the ability of the kidney to tolerate hypoxia.

Objective To observe the function of kidney compromised and histopathological changes of renal tissue in heatstroke rats under the dry-heat atmosphere of desert in order to find the mechanism for provide a rationale of clinical treatment.Methods Forty-eight anaesthetized rats were divided into six groups (n =8 in each group):mild heatstroke group with its control group,moderate heatstroke group with its control group,and severe heatstroke group with its control group.The rats of three heatstroke groups were placed in a dry-heat environment prolonged with 41 ℃ and 10％ humidity,and the three control groups were placed in a room temperature prolonged with 25 ℃ and 35％ humidity.At heatstroke status of each group,arterial blood samples were collected from each group for testing creatine kinase (CK),creatinine (CREAT),uric acid (UA) and urea,kidney tissues and muscle tissues were taken for pathological examinations.Results Pathological examination showed dilatation and congestion of vessels,thrombosis,bleeding,protein casts and endothelium injury were found in the heatstroke rats.In mild heatstroke,the pathological changes mainly manifested as dilatation and congestion of vessels ; in moderate one,the changes mainly manifested as thrombosis; and in severe one,changes mainly manifested as bleeding and protein casts.Muscle tissues presented rhabdomyolysis,especially in severe one.The differences in biomarkers between three different degrees of heatstroke showed statistical significance (CK:F =136.204,P =0.000;CREAT:F =172.865,P=0.000; UA:F=546.454,P=0.000; urea:F=73.823,P=0.000).There was no significant difference in UA between mild heatstroke group and its control group (t =1.943 ;P =0.072),and the differences in rest biomarkers showed statistical significance between each heatstroke group and its control group (P =0.000).Conclusions The kidney injury developed during heatstroke in dry-heat environment of desert suggests that we should be alert to disseminated intravascular coagulation (DIC),myolysis and acute kidney failure,and should monitor the blood biochemical changes closely and treat it energetically,rescuing a heatstroke patient in dry-heat environment of desert.

Objective To investigate the effect of S100A4 silencing on tumor related gene COX-2,bcl-2,Surviving,MMP-9 mRNA expressions of pancreatic cancer BxPC-3,AsPC-1 cells,and explore their relationship.Methods Small interfering RNA interfering S100A4 gene (siRNA-S100A4) was applied to transfect human pancreatic cancer BxPC-3,AsPC-1 cells,and nonhomologous siRNA-C was used as negative control,and cells without transfection were used as control group.The expressions of S100A4,COX-2,Survivin,MMP-9,bcl-2 mRNA after interference were detected by using RT-PCR.Results S100A mRNA expressions of BxPC-3's control group,siRNA-C group,siRNA-S100A4 group were 0.661 ± 0.023,0.659 ± 0.043,0.379 ± 0.039,and expressions of COX-2 mRNA were 0.760 ± 0.026,0.830 ± 0.017,0.443 ±0.006,and expressions of Survivin mRNA were 0.948 ± 0.049,0.909± 0.081,0.068 ± 0.006,and expressions of bcl-2 mRNA were 0.462 ±0.018,0.421 ±0.049,0.184 ±0.025,and expressions of MMP-9 mRNA were 0.813 ± 0.008,0.908 ± 0.063,0.246 ± 0.027.S100A mRNA expressions of AsPC-I's control group,siRNA-C group,siRNA-S100A4 group were 0.641 ± 0.042,0.626-± 0.053,0.320 ± 0.081,and expressions of COX-2 mRNA were 0.727 ± 0.021,0.743 ± 0.025,0.560 ± 0.035,and expressions of Survivin mRNA were 0.994 ± 0.032,0.984 ± 0.049,0.063 ± 0.005,and expressions of bcl-2 mRNA were 0.458 ±0.004,0.537 ± 0.046,0.181 ± 0.007; and expressions of MMP-9 mRNA were 0.698 ± 0.011,0.718 ± 0.073,0.199± 0.013.The expressions of S100A,COX-2,Survivin,bcl-2,MMP-9 mRNA in groups with siRNA-S100A4 transfection were significantly lower than those of siRNA-C group and control group (P ＜0.01),but the difference between siRNA-C group and control group was not statistically significant.Conclusions S100A4 plays a role in the pathogenesis of pancreatic cancer through up-regulation of COX-2,Survivin,bcl-2,MMP-9 expressions.

Objective To investigate the value of urinary calprotectin in differential diagnosis between prerenal and intrinsic pediatric acute renal injury(AKI).Methods A total of 68 cases with AKI were enrolled in this study,and they were divided into prerenal AKI group(25 cases) and intrinsic AKI group(43 cases) according to their tissue perfusion.The general data was collected,and the blood urea nitrogen(BUN),serum creatinie(Scr),BUN/Scr,potassium,fractional excretion of filtrated sodium(FENa),urine osmotic pressure,B-type natriuretic peptide (BNP),urinary calprotectin,neutrophil gelatinase-associated lipocalin (NGAL),kidney injury molecule 1 (Kim-1) were recorded and compared between the 2 groups.Results There were significant differences between prerenal AKI group and intrinsic AKI group in Scr[(439.0 ± 278.0) μmol/L vs.(603.0 ± 286.0) μmol/L,t =2.30,P ＜ 0.05],BUN/Scr (20.58 ±5.62 vs.14.93 ±4.32,t =4.65,P＜0.05),FENa[(1.5 ±0.6)％ vs.(8.1 ±2.6)％,t =12.46,P＜ 0.05],BNP[95.6(54.0,109.4) ng/L vs.512.3(320.1,520.3) ng/L,Z =2.21,P ＜0.05],urinary calprotectin [20.7(4.3,42.4) μg/L vs.402.4(60.1,498.7) μg/L,Z=3.13,P＜0.05] and NGAL[74.9(14.5,365.5) μg/L vs.684.2(56.2,1 502.5) μg/L,Z =2.35,P ＜0.05].Receiver operating characteristic curve analysis showed that urinary calprotectin[area under the curve(AUC) =0.940] and BNP(AUC =0.909) both had higher value in differential diagnosis.When the cut off value of calprotectin was 240.6 μg/L,its specificity was 96.0％ and the sensitivity was 86.0％.When the cut off value of BNP was 120.6 ng/L,its specificity was 92.0％ and the sensitivity was 90.7％.The diagnostic accuracy was low in Scr,but moderate in BUN,Scr,FENa and NGAL.BUN,potassium,urine osmotic pressure and Kim-1 had no diagnostic value.Conclusions Urinary calprotectin may have higher diagnostic value in the differential diagnosis between prerenal and intrinsic pediatric AKT.It can be used in the clinical diagnosis as a reference index.

Objective To investigate the effect of Curcumin on rats with severe acute pancreatitis associated renal injury and explore the possible mechanisms.Methods A total of 72 rats were randomLy divided into sham-operated group(S group, n =24), severe acute panceratitis with renal injury group(M group, n =24) ,Curcumin-treated group(Cur group,n=24).The S and M groups were given 1.5 ml saline through intragastric administration 3 hours before operation,while the Cur group was fed with same amount of Curcumin diluent(200 mg/kg).The pancreas and pancreatic tail-segment was dissociated and the head of pancreas was occlused in rats to form the model,blood vessel forceps was loosed after 3 hours.All the rats were sacrificed at 12 h,24 h, 36 h and 48 h after modeling.The level of ascites, serum amylase, creatinine, blood urea nitrogen were detected and the pathological chang of pancreas was observed under light microscope.Take the right kidney for Superoxide Dismutase (SOD) determination and the expression of hypoxia inducible factor-1αmRNA in the right kidney was detected with realtime polymerase chain reaction (RT-PCR).Results Compared with Cur group, the level of ascites, serum amylase, creatinine, blood urea nitrogen in M group were significantly increased, but the activity of SOD, the express of hypoxia inducible factor-1αmRNA had a significant decline (P＜0.05).The tissue damage of pancreas and the kidneys became more serious.But a better performance was to be found in the function of the Cur group's kidney and pancreas, and the the difference was statistical significance (P ＜0.05).Conclusion Curcumin has a good protective effect on severe acute pancreatitis associated renal injury.It may be through up-regulation expression of HIF-1α mRNA and increase the activity of superoxidase dismutase, then reduce the cell apoptosis and necrosis of the kidney, improve the ability of the kidney to tolerate hypoxia.

This study proposed to use Term Frequency - Inverse Document Frequency (TF-IDF) relative entropy as knowledge representation method between symptoms and syndrome. TF-IDF was originated from text mining. It was an important method in the automatic text categorization. TF-IDF also represented the automatic categorization idea in traditional Chinese medicine (TCM) syndrome. It was based on the fact that the higher frequency of one symptom in specific syndrome, the stronger ability to distinguish this syndrome (TF); and the more wide range of one symptom in all syndrome, and the lower ability to distinguish a syndrome (IDF). It was verified with specific examples.