Objective To explore the clinical effects of Jiawei Bazhen in treatment of fracture nonunion in children .Methods 60 cases of patients with fracture nonunion from December 2014 to June 2015 in Weinan Maternity and Child Health Care Hospital were divided into experimental group and control group according to random number table, 30 cases in each group.The control group were treated by Shangke Jiegu tablet combined with staphylococcal enterotoxin C injection, and the experimental group were treated by Jiawei Bazhen combined with staphylococcal enterotoxin C injection, with a consecutive treatment of 6 weeks.The efficacy, arthritis symptom score, serum bone morphogenetic protein-7(BMP-7) and vascular endothelial growth factor( VEGF) were compared between two groups.Results The total effective rate in experimental group were higher than that in control group (χ2 =6.667,P<0.05).The arthritis symptom score in experimental group was lower than that in control group(P<0.05).The serum levels of BMP-7 and VEGF in experimental group were higher than those in control group(P<0.05).There was no significant difference in adverse reactions between two groups(χ2 =1.086,P>0.05).Conclusion Jiawei Bazhen could improve the clinical symptoms, increase the levels of BMP-7 and VEGF, and promote the bone fracture's concresc in children with fracture nonunion, with fewer adverse reactions, which has distinct clinical curative effect.

ObjectiveTo determine the role of mammary ductoscopy in the evaluation and intraductal therapy for nipple discharge.MethodsIn this study 3280 patients with nipple discharge underwent mammary ductoscopy. Ductoscopy revealed space occupying lesions in 1018 patients who subsequently underwent surgery; 2260 patients with no-space occupying lesion underwent ductoscopically guided duct lavage.ResultsSpace occupying lesion was often seen in patients with bloody discharge,single duct nipple discharge,discharge in unilateral breast and lesions located in general or levelⅠ - Ⅱ duct.Non-bloody discharge,multiple duct with nipple discharge and bilateral breast involved and lesions at multi-level ducts were common in patients with no-space occupying lesions. Ductoscopically guided duct lavage was curative in 88.72％ among 2260 cases undergoing lavage.ConclusionsSpace occupying lesion should be suspected in patients with bloody discharge,single duct nipple discharge and unilateral breast involving lesion and lesions located in the general or level Ⅰ - Ⅱ duct system;Mammary ductoscopy is useful tool in the intraductal therapy for non-space occupying lesions.

Objective To explore the related structures of retrosigmoid approach by microanatomy and virtual anatomy and provide a reliable approach with more morphologic data. Methods Twenty sides of 10 adult cadaveric heads were dissected to simulate retrosigmoid approach under the microscope. The neurovascular structures of pontocerebellar trigone were observed, and the related structures were simultaneously measured based on the junction of superior petrosal sinus and sigmoid sinus and internal acoustic pore. The internal auditory canal was opened by drilling the margin of the internal auditory meatus and its structures were watched. With the help of Dexotroscope system, the data of five patients' CT and MRI were applied to reconstruct and anatomize the structure of retrosigmoid approach. Results It was found that the distance from the junction of superior petrosal sinus and sigmoid sinus to the trigeminal nerve was (38.50±2.64)mm, to the acoustic-facial bundle (27.80±2.25)mm, to the glossopharyngeal nerve (32.70±2.11)mm, to the hypoglossal nerve (44.30±2.05)mm, and the distance from internal acoustic pore to the trigeminal nerve was (5.68±1.55)mm, to the abducent nerve (13.80±1.81)mm, to the tentorium of cerebellum (5.00±0.66)mm, to the glossopharyngeal nerve (6.34±1.24)mm. The pontocerebellar trigone was divided into the anterior compartment, the middle compartment, the posterior compartment built on the acoustic-facial bundle and the glossopharyngeal nerve. Their structures were displayed after drilling the margin of the internal auditory meatus. Dexotroscope system clearly displayed asterion, the angle of transverse and sigmoid sinus, jugular foramen, internal acoustic pore, basilar artery and its branches, and theirs spatial relationship.Conclusion The three compartments of the pontocerebellar trigone are helpful to understand the feature of the neurovascular layer, the measurement is favorable to quantize the relation of the related structures and to judge the space of each compartment. Recognizing the anatomical marker of internal acoustic pore can support preservation of the inner structures. Virtual anatomy of Dexotroscope system can display local anatomical structure respectively. Both microanatomy and virtual anatomy have their advantages and disadvantages respectively and integration can be beneficial to understand neurovascular structures in the pontocerebellar trigone.

Objective To evaluate the effect and safety of use of tirofiban in percutaneous coronary interventional therapy (PCI) in elder patients with acute ST segment elevation myocardial infarction (STEMI). Methods Sixty-five patients with acute STEMI were divided into two groups: 31 patients in the elderly group (≥70 years) and 34 patients in the younger group (0.05). Conclusion It is safe and effective to administer tirofiban to elderly patients with acute STEMI undergoing PCI.

0.05). Conclusion CCM is a proper scaffold,on which KC and FB of tympanum maintain satisfactory proliferation and collagen secretion activity.

Objective To discuss the impact of a immunosuppressive protocol using tacrolimus combined with mycophenolate without steroid on glycometabolism after liver tansplantation (LT).Methods 295 adult liver transplant recipients were under investigation and divided into two groups,to receive immunosuppression therapy using tacrolimus and mycophenolate with (n =142) or without steroid (n =153).The fasting blood-glucose level,rate of hyperglycemia,infection and metabolic complications were followed up at 1st,2nd,4th,8th,12th,16th,20th and 24th week after LT.Results There were no significant differences between two groups in gender,age.body weight and FBG level before LT.In both groups,the FBG levels were significantly elevated immediately and reached the peak at 1st week after LT,then gradually decreased over time post-LT.The FBG level and rate of hypcrglycemia were significantly lower in steroid-free group than in steroid group in each observation time point with the differences being significant (P＜0.05) at 4th week post-LT.The overall rate of hyperglycemia was 52.9％ in steroid free group and 76.8％ in steroid group with the difference being significant between the two groups (P＜0.05) and a risk ratio of 2.94 (steroid-free group versus steroid group).The rate of acute rejection was slightly higher in steroid-free group (8.50 ％ ) than in steroid group (7.75％ ) (P ＞ 0.05 ).Also the incidence of intention badness,infection and hypercholesterinemia was significantly lower in steroid group than in steroid-free group.Conclusion The immunosuppressive protocol without steroids is safe and effective of reducing the risk of hyperglycemia and metabolic complications after LT.

Objective:To investigate the effects of 5-aza-2′deoxycytidine(5-aza-dC),a DNA methyltransferase (DNMT)inhibitor, on the methylation status of the RECK gene and the invasion of salivary adenoid cystic carcinoma cell lines.Methods:Methylation-specific PCR,Western blot analysis and quantitative real-time PCR were used to investigate the methylation status of RECK gene and the expression of RECK mRNA and protein in SACC cell lines.The invasive ability of SACC cells was examined by transwell assay. Results:Promoter methylation was only found in ACC-Mcell line and not in ACC-2 cell line.Treatment of ACC-Mcells with 5-aza-dC partially reversed the hypermethylation status of the RECK gene and significantly enhanced the expression level of mRNA and pro-tein of RECK,suppressed ACC-Mcell invasive ability.Conclusion:5-aza-dC can inhibit ACC-Mcell invasion by reversal of hyperm-ethylation status of RECK gene.

Objective To evaluate the influence of precise liver resection techniques on intestinal permeability in the diseases needing liver resection.Methods Eighty-seven patients needing liver resection were randomized to receive the precise liver resection (n =58,PLR group) or the conventional liver resection (n =29,CLR group).D-lactate and and endotoxin in abdominal fluid were detected in all the patients.The abdominal fluid bacteria cultures were performed.Results The postoperative hospitalization time,the needed time of blood routine,temperature,and oppetite resuming were significantly shorter in PLR group than those in CLR group (t ≥7.36,P ＜ 0.01) ; The postoperative abdominal effusion was significantly less in PLR group than that of CLR group(t ≥ 14.17,P ＜0.01).The abdominal fluid concentrations of D-lactate and endotoxin in operation or at 1d after operation were significantly higher than those at 5d after operation in both groups(t ≥10.41,P ＜0.01).Those parameters decreased significantly at 2d after operation,returned to the normal level at 3d after operation in PLR group,and those parameters were significantly lower in PLR group than those in CLR group at the same time phase after postoperative 2 or 3 days (t ≥9.23,P ＜0.01) ; Those parameters began to drop at 3d after operation,returned to the normal level at 5d after operation in CLR group.The positive rate of abdominal fluid bacteria cultures was significantly lower in PLR group than that in CLR group(13/29) (x2 =23.51,P ＜ 0.01).Conclusions The precise liver resection techniques had an important influence on intestinal permeability in the diseases needing liver resection.

Objectives To explore polymorphisms of CD152 gene promoters (-1722T/C,-1661A/G) and exon1 (+49A/G) in children with idiopathic ischemic stroke and assess the association between these polymorphisms with the disease. Methods Us-ing the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, polymorphisms in the CD152 exon1 region (+49A/G) and promoter regions (-1722T/C,-1661A/G) were genotyped in 51 Han children with idiopathic ischemic stroke and 74 healthy Han children. Results The CD152 genotypes in control group and idiopathic ischemic stroke children were consistent to principle of Hardy-Weinberg Equilibrium (HWE) byχ2 test. The CD152+49GG genotypes and G allele frequency in the patients showed a signiifcant increase compared to the controls (χ2=7.053, 6.351, P<0.05). However, the CD152-1722T/C,-1661A/G genotypes and allele frequency showed no signiifcant difference between 2 groups (P>0.05). Clinical features (hemi-paresis, dysarthria, seizures, consciousness change, and preceding infections) did not show signiifcant correlation with genotypes and frequency of the CD152+49 polymorphisms in children with idiopathic ischemic stroke (P>0.05). Conclusions The CD152+49A/G polymorphisms may relate to idiopathic ischemic stroke.

Objective To detect the best phase and best tube voltage for the diagnosis of small (diameter ≤ 3 cm) clear cell renal cell carcinoma with dual-energy dual-phase CT.Methods Image manifestations of 27 patients with small (diameter ≤ 3 cm) ccRCCs confirmed by pathology were retrospectively analyzed.All subjects underwent dual-energy biphase (early corticomedullary and delayed phase) scan preoperatively.Two senior radiologists analyzed the images in consensus.The definition of images in different phases and with different tube voltage was classified into 4 levels and was compared by Wilcoxon and Friedman test.The attenuation of the lesions and the adjacent renal parenchyma,the SD value of the anterior abdomen fat were measured.The contrast noise ratio (CNR),lesion kidney ratio (LKR) and the early corticomedullary phase and delayed phase value were calculated.They were all compared with oneway ANOVA.Results The score of definition of lesions in early corticomedullary phase at 80 kV,140 kV and average-weighted 120 kV were 3.30 ± 0.87,2.81 ± 0.92 and 3.11 ± 0.85,respectively,which in delayed phase were 3.70 ±0.54,3.30 ±0.82 and 3.52 ±0.64,respectively.Definition of lesions was better in delayed phase than that in early corticomedullary phase (Z =-2.296,-2.446 and-2.392,respectively; P ＜ 0.05).Either in early corticomedullary phase or in delayed phase,CT value,noise value and CNR were the highest on 80 kV images,which were(302 ± 80)HU,(16.2 ± 2.2) and (4.1 ± 3.4) in corticomedullary phase and (152 ± 31) HU,(16.4 ± 2.7) HU,and (4.7 ± 1.7) in delayed phase.The change of lesion attenuation between early corticomedullary phase and delayed phase on 80 kV,140 kV and averageweighted 120 kV images were (150 ± 76),(72 ± 33) and (96 ± 46) HU,respectively.There was significant difference among the three groups (F =4.541,P ＜ 0.01).Conclusions Delayed phase scan is in favor of small clear cell renal cell carcinoma display.80 kV images are the best for detecting and qualitation of small clear cell renal cell carcinoma when compared with 140 kV and the average-weighted 120 kV images.