Objective To explore the surgical treatment of intra -articular calcaneal fractures with bone nodules joint angle in the preoperative and intraoperative evaluation of prognosis of postoperative analysis.Methods 22 cases of affected joint surface after calcaneal fractures,open reduction and internal fixation with steel plate in the operation treatment.Used Sanders classification:preoperative,intraoperative,postoperative again calcaneal tubercle joint angle measurement.According to the Maryland foot scoring system to evaluate postoperative effect.Results All patients were followed up for 8 to 20 months.The excellent and good rate of the patients was 90%,the postoperative complications:heel broadening,subtalar arthritis in 2 cases,poor healing in 2 cases (after the treatment and healing). Conclusion It has high value of the calcaneal tubercle joint angle measurement in the joint surface after calcaneal fractures.

Objective To explore the significance of sample cultivation and drug resistance of the patients in PICU with severe lower respiratory tract specimens.Methods 1 107 pathogenic bacteria of lower respiratory tract samples collected were analyzed and the drug resistance was kept watch on.Results A total of 1107 samples were cultured into 948 strains of pathogens,with the positive rate of 85.64%,and 616 strains of Gram negative bacteria accounting for 64.98%,of which 145 strains of Pseudomonas aeruginosa(15.30%),Klebsiella pneumoniae 135(14.24%),Acinetobacter spp 131(13.82%),large intestine Egypt Greek bacteria 89(9.4%);Gram positive cocci 129(13.61%),the main pathogen was staphylococcus aureus and Fungi 203(21.41%),the main pathogen was candida albicans.Carbapenems was the most active antibiotics for gram negative bacill,and vancomycin for gram positive cocci.Conclusion Infectious bacteria have high selectivity to the sensitive antibiotics,and doctors should carefully use antibiotic according to the susceptibility test results in order to reduce hospital infection and the emergence and spread of resistant strains.

OBJECTIVETo observe the immediate antihypertensive effect of guasha combined with bleeding therapy for mild (grade I) hypertension.

METHODSThirty patients with mild (grade I) hypertension and 30 cases with normal blood pressure were compared. Areas and acupoints in governor vessel, meridian of foot-taiyang, meridian of hand-yangming and meridian of foot-yangming were scraped for 3 times, which was followed by bleeding therapy. The blood pressures after each guasha and bleeding therapy were recorded as well as the skin temperature in Dazhui (GV 14) after each guasha. The treatment was given once a week and totally 4 treatments were given.

RESULTSThere were significant antihypertensive effects after the first guasha, the second guasha and the third guasha and bleeding therapy (all P<0.01), in which guasha combined with bleeding therapy had the most significant antihypertensive effect (P<0.01). The skin temperature in Dazhui (GV 14) was obviously increased after three times of guasha (all P<0.01).

CONCLUSIONGuasha or combined with bleeding therapy has better antihypertensive effect for mild hypertension, which is likely to be related with warming stimulation on meridians and acupoints.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Case-Control Studies ; Combined Modality Therapy ; Female ; Hemorrhage ; Humans ; Hypertension ; physiopathology ; therapy ; Male ; Meridians ; Middle Aged

Animals ; Apoptosis ; Hypoxia-Inducible Factor 1, alpha Subunit ; Hypoxia-Ischemia, Brain ; genetics ; pathology ; Neurons ; cytology ; metabolism ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Transcription Factors ; genetics

Animals ; Animals, Newborn ; Brain ; metabolism ; pathology ; Caspase 3 ; Caspases ; metabolism ; DNA-Binding Proteins ; genetics ; Gene Expression ; Hypoxia, Brain ; genetics ; physiopathology ; Hypoxia-Inducible Factor 1 ; Hypoxia-Inducible Factor 1, alpha Subunit ; Immunohistochemistry ; Ischemic Preconditioning ; Nuclear Proteins ; genetics ; RNA ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors

Objective To investigate the role of pancreatic β cell on pancreatic regeneration following experimental acute pancreatitis.Methods Eighty-seven SD male rats were randomly divided into four groups:control group ( n =15 ),STZ group ( n =24),L-Arg group ( n =24 ),STZ + Arg group ( n =24).60 mg/kg of STZ was administrated by intraperitoneal injection to induce the diabetes model.2.5 g/kg body weight of LArg was administrated by intraperitoneal injection to induce the acute pancreatitis model.The rats were sacrificed 1,3,5,7 d later and the serum levels of amylase and glucose were measured.Relative pancreatic weight (pancreatic weight/body weight) were measured.Pancreatic tissue underwent routine pathologic examination,and the percentage of area of necrosis and tissue transformation was calculated.The expression of Reg4 and insulin was performed by immunofluorescence.Results Serum level of glucose significantly increased after STZ injection.After L-Arg injection,serum level of amylase significantly increased,and there was pancreatic tissue edema,necrosis,infiltration of inflammatory cells,which suggested the successful model induction.The percentage of area of necrosis in STZ + L-Arg group was (71.6 ± 6.0) ％ at the 3rd day,which were significantly higher than (42.3 ± 4.0 ) ％ in L-Arg group; the percentage of area of transformation was (45.6 ± 5.4) ％,which were significantly lower than (78.5 ± 6.4) ％ in L-Arg group.Expression of Reg4 in pancreatic islets of STZ + L-Arg group was significantly lower than those in L-Arg group.Conclusions STZ impairs pancreatic β cells,aggravates pancreatic damage following L-arginine induced pancreatitis and inhibits pancreatic regeneration.

Objective To explore the expression of HCK gene during the cardiomyocyte differentiation of mouse embryonic stem cells and analyze the role of HCK gene in maintenance of pluripotency of embryonic stem cells.Methods Mouse embryonic stem cells were cultured,then induced to differentiate into cardiomyocytes.Total RNAs were isolated from mouse embryonic stem cells in the differentiation days:0 day(D0),the second day(D2),the fourth day(D4),the sixth day(D6),the eighth day(D8),respectively.The levels of HCK mRNAs were assessed by the method of semi-quantitive reverse transcriptase-polymerase chain reaction(RT-PCR).In the meanwhile,Total proteins were also isolated from mouse embryonic stem cells in the differentiation D0,D2,D4,D6,D8,and the levels of HCK proteins were evaluated by Western-blot.Results HCK mRNAs could be detected in the mouse embryonic stem cells in D0 and D2,however,they were undetectable from D4 to D8.The expression of HCK mRNAs was rapidly down-regulated during cardiomyocyte differentiation of mouse embryonic stem cells.Expression of HCK proteins,which coincided with HCK mRNAs,down-regulated during differentiation and couldn't be detected in D4.Conclusions With the cardiomyocyte differentiation of mouse embryonic stem cells,the expression of HCK in the levels of mRNA and proteins are sharply down-regulated;HCK may play an important role in maintaining the pluripotency of embryonic stem cell.

Objective To compare the clinical outcomes of gonadotropin-releasing hormone (GnRH) antagonist (GnRH-ant) fixed protocol with GnRH agonist (GnRH-a) long protocol in infertile patients with normal ovarian reserve function in their first in vitro fertilization-embryo transfer (IVF-ET) cycle,and to explore the feasibility and advantage of GnRH antagonist protocol performed in normal responders.MethodsFrom January 2011 to June 2011,771 infertile women with normal ovarian reserve function underwent their first IVF or intracytoplasmic sperm injection (ICSI) cycles in Peking University Third Hospital,which were divided into 245 cycles in GnRH-ant fixed protocol group ( GnRH-ant group) and 526 cycles in GnRH-a long protocol group ( GnRH-a group).The data of general demographic,treatment and clinical outcome were compared between two groups.ResultsAge,infertile duration,body mass index (BMI),baseline serum follicle-stimulating hormone (FSH) and estradiol levels between two groups did not reached statistical difference (P ＞ 0.05 ).The level of estradiol was (12 289 ± 6856) pmol/L in GnRH-ant group and (14934±8007)pmol/L in GnRH-a group at day of hCG injection.The mean length of stimulation was ( 10.3 ± 1.2) days in GnRH-ant group and ( 12.8 ± 1.6) days in GnRH-a group.The dose of gonadotropin was (2013 ± 607 ) U in GnRH-ant group and (2646 ± 913 ) U in GnRH-a group.The number of ovum was 15 ± 7 in GnRH-ant group and 17 ± 8 in GnRh-a group.Those clinical parameter all reached statistical difference (P ＜0.05 ).The number of embryo was 7 ±4 in GnRH-ant group and 8 ± 5 in GnRH-a group,the rate of clinical pregnancy was 40.9％ (94/230) in GnRH-ant group and 45.6％ (216/474)in GnRH-a group,the rate of implantation was 26.1％ (128/490)in GnRH-ant group and 30.9％ (307/994) in GnRH-a group,the rate of continuing pregnancy was 38.7％ ( 89/230 ) in GnRH-ant group and 42.6％ (202/474) in GnRH-a group,those parameter did not reach statistical difference (P ＞ 0.05).The rate of moderate or severe ovarian hyperstimulation syndrome was 2.4％ ( 6/245 ) in GnRH-ant group and 4.2％ (22/526) in GnRH-a group,which did not show significant difference ( P ＞ 0.05 ).ConclusionIn the first IVF or ICSI cycle of the patients with normal ovarian reserve function,the fixed GnRH-ant protocol could get the same satisfied clinical outcome,and it is more economic,convenient and safer compared with low dose depot GnRH-a long protocol.

Objective To analyze the efficacy of salvage therapy for postoperative recurrence or metastasis in patients with stage T3 N0 M0 thoracic esophageal squamous cell carcinoma ( ESCC ) and its influencing factors. Methods A retrospective analysis was performed in 108 patients with postoperative recurrence or metastasis in stage T3 N0 M0 thoracic ESCC who were admitted to our hospital from 2008 to 2009. In those patients, 59 had locoregional recurrence ( LR) , 26 distant metastasis ( DM) , and 23 both LR and DM. After recurrence, 53 patients received supportive therapy, 32 salvage radiotherapy, 9 chemotherapy, and 14 chemoradiotherapy. The overall survival ( OS) rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The univariate and multivariate prognostic analyses were performed using the log?rank test and the Cox regression model, respectively. Results The follow?up rate was 100%. In all patients, the 1?, 3?, and 4?year OS rates were 29?9%, 16?5%, and 14?4%, respectively;the median OS time was 6 months. The univariate analysis showed that recurrence pattern and salvage therapy were associated with OS after recurrence ( P=0?017;P=0?000) . The multivariate analysis showed that salvage therapy was the only independent factor for OS after recurrence ( P=0?000) . Compared with supportive therapy, the risk of death after chemotherapy, radiotherapy, or chemoradiotherapy was reduced by 76?7%, 76?7%, and 86?1%, respectively. Conclusions The treatment outcomes are poor in patients with postoperative recurrence of stage T3 N0 M0 thoracic ESCC. Salvage therapy can substantially improve OS after recurrence.

ObjectiveTo analyze the differential expression of microRNA (miRNA) and its significance in patients with neonatal necrotizing enterocolitis (NEC).MethodsTwenty-five patients diagnosed with NEC with Bell stage≥Ⅱ, and 25 non-NEC patients as control group admitted to Guangzhou Women and Children's Medical Center between October 2014 and November 2015 were collected. White blood cells were extracted from the peripheral blood. Five samples were selected randomly each from NEC group and control group, and sequenced by second-generation Illumina high-throughput sequencing, screened for differentially expressed miRNA and analyzed for target genes prediction and biological function. The rest samples of the two groups were detected by real-time fluorescent quantitative polymerase chain reaction technology (RT-qPCR), the results were used to validate the results of high-throughput sequencing. Differentially expressed miRNA in the two groups of data was analyzed using DEGseq software.P<0.05 was considered statistically significant.P<0.01,q<0.001 and丨Log2 Ratio丨≥1 were taken as criteria for screening the differential expression. The differential expressions of miRNA in NEC group and control group were analyzed by cluster analysis using MeV4.6 software.ResultsA total of 482 miRNAs were differentially expressed in the two groups, with significant difference (P<0.05). Among them, 126 were known miRNAs with significantly differential expression in the two groups, with 58 being up-regulated and 68 being down-regulated. The results of up-regulated miRNAs (hsa-miR-223-5p,-183-3p,-222-5p) and down-regulated miRNAs (hsa-miR-23b-5p,-150-5p,-146a-3p,-1298-5p) were confirmed to be consistent with the results of sequencing. Bioinformatics analysis showed that the target genes with differential miRNA expression mainly involved Toll-like receptor signal transduction pathway, mitogen-activated protein kinase pathway, JAK-STAT and other signal transduction pathways.ConclusionsThere are significantly differential expressions of miRNAs in peripheral white blood cells of NEC neonates. These miRNs may be involved in the occurrence and development of NEC via adjusting different target genes to regulate the signal pathway.