Objective To investigate the operative treatment of displaced intra-articular fractures of the calcaneus using a small lateral incision approach.Methods Thirty-one patients with 32 intra-articular calcaneal fractures,were treated with open reduction and internal fixation through a small lateral incision approach from October 2004 to April 2006.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.According to Sanders classification,there were 21 typeⅡfractures and 11 typeⅢfractures.The first change of dressing was done on the second day after operation.The residual blood clots in the wounds were cleaned as much as possible when the drainage sheet was removed.The operated foot was bandaged with pressure dressing of cotton pad.Results After an average follow-up of 10.5 months(range,3 to 18 months),no soft tissue com- plications were found,and all had acceptable reduction.The preoperative X-ray film showed that B(?)hler angle was 6.84??9.36?,Gissane angle was 106.04??12.03?.The postoperative X-ray film demonstrated that B(?)hler angle was 32.06?+6.87?,Gissane angle was 115.81??9.48?,and the difference was statistically significant(P＜0.01).According to the AOFAS evaluation system for Ankle-Hindfoot,two feet scored 60-70 points,nine feet 70-80 points,16 feet 80-90 points and five feet 90-100 points.Condusion The small lateral incision approach is a good option for management of calcaneus fractures,because it causes minimal soft tissue damage,provides excellent exposure,and leads to convenience for later removal of internal fixators and subtalar arthrodesis.

Objective To investigate the therapeutic effect of buflomedil hydiochoride for on jection inpro- gressive ischemic stroke.Methods 60 patients with cerebral infarction were divided into buflomedil hydrochoride for injection treatment group and control treatment.Then the nepal function deficits of patients were evaluated before and after 15 days.Serum MMP-9 levels in vein blood samples of ischemie stroke were detected.Results The inci- dence rate of progressive ischemic stroke in treatment group of buflomedil hydrochoride for injection was lower than that of control treatment group(P

Based on the performance management theories and methods, the factors affecting clini-cal teachers' teaching motivation were analyzed in domestic university affiliated hospitals. In consideration of the functional position of university affiliated hospitals and the responsibilities of clinical teachers, the Delphi, KPI and other methods were used to identify key index and respective weight of teaching perfor-mance evaluation, therefore the teaching performance evaluation system including teaching load, teaching quality and teaching capacity in three dimensions were constructed. Then this index system was applied to a university affiliated hospital as an example to verify its feasibility, scientificity and effectiveness. Further-more, the evaluation system was embedded to information platform of educational administration manage-ment, and was proved as a useful teaching performance information management tool that provided reference for hospital performance payment distribution, title evaluation and recommendation, and teaching awards evaluation at all levels, etc. Consequently, theoretical and methodological references were provided for improving clinical teachers' teaching enthusiasm.

Objective To study the feature of neonatal infections and characteristics of antibiotic treatment in a tertiary children ' s hospital. Methods Clinical data including incidence of infection, primary disease,species of bacteria, complication and antibiotic utilization in hospitalized patients from Jan. 2010 to Dec. 2012 were retrospectively reviewed using their medical records. Results Among 1826 patients admitted to neonetal surgery ward, 542 infants ( 29. 7％) were with infection. The incidence of antibiotic resistance was 23. 51％. The top five infectious diseases were:perianal abscess, necrotizing enterocolitis, colicitis, omphalitis and subcutaneous gangrene. 12 cases of multi-resistant infection were cured by non-restricted antibiotics. 109 were cured by restricted antibiotics. And other 7 were cured by special antibiotics. No death nor multi-resistant nosocomial infection were found. Risk factors including multi-site infection, premature or low birth weight infants, liver, kidney or heart dysfunction,fever lasting more than 3 days after antibiotic therapy, septic shock, sepsis, digestive tract perforation and peritonitis,were vital in choosing specific antibiotics. Conclusions Infection is one of the most common diseases in neonatal surgery ward, with major pathogens sensitive to antibiotics. The clinical characteristics and drug sensitive test are conductive to the reasonable use of antibiotics. Special antibiotics can be used directly in patients with risk factors Clinical doses of antibiotics in neonates depend on the monitoring of drug concentration.

OBJECTIVETo observe the efficacy of catgut implantation at back-shu points in treatment of mild perimenopausal depression of kidney, deficiency and liver stagnation syndrome and analyze its essential function on target symptoms.

METHODSForty-five cases were randomized into a catgut implantation group (23 cases) and atid acupuncture group (22 cases). In the catgut implantation group, catguts were implanted at Shenshu (BL 23), Ganshu (BL 18), Xinshu (BL 15), Pishu (BL 20), etc., once every week. In the acupuncture group, the conventional acupuncture was applied to the same acupoints as the catgut implantation group, once every two days. The: treatment of 4 weeks made one session, and continuous 2 sessions were required. The efficacy was evaluated in, 2 sessions. The follow-up started in the 12th week. Before treatment, after treatment and in the follow-up period, Kupperman score and the total score in Hamilton depression scale (HAMD), as well as the factor score were observed in the patients separately.

RESULTSKupperman score, the total HAMD score and the scores in the items of anxiety/somatization, retardation, sleep disorder and cognitive disorder after treatment were all reduced significantly as compared with those before treatment in the two groups (P<0.01, P<0.05). In the follow-up period, the difference in Kupperman was not significant in comparison with that after treatment in the catgut implantation: group (P>0.05). The total HAMD score and sleep disorder were reduced significantly as compared with those after treatment in the catgut implantation group (both P<0.01); in the acupuncture group, Kupperman score, the total HAMD score and sleep disorder were all increased as compared with those after treatment (all P<0.05). In; the catgut implantation group, the total HAMD score was lower than that in the acupuncture group (P<0. 05), and the scores in the items of retardation and sleep disorder were reduced significantly as compared with those in the acupuncture group (both P<0.01).

CONCLUSIONThe catgut implantation at back-shu points alleviates perimenopasual sympton is in patients of mild perimenopausal depression of kidney deficiency and liver stagnation syndrome. This therapy effectively relieves depressive disorders by regulating the target symptoms such as anxiety/ somatization, retardation, sleep disorder and cognitive' disorder. The long-term efficacy of this therapy is better than the conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Catgut ; Depressive Disorder ; physiopathology ; therapy ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Middle Aged ; Perimenopause ; psychology ; Treatment Outcome

Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; adverse effects ; Female ; Humans ; Mucormycosis ; etiology

Brain ; surgery ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Humans ; Postoperative Period

Objective To determine the effect of endomorphin (EM) on colonic electromyography activity and investigate the pathogenesis of slow transit constipation (STC). Methods An experimental rat model of slow transit constipation was constructed by contract laxatives mixed with the feed. The changes of colonic electromyography and reaction to endomorphin 1 and endomorphin 2 were examined. Results Compared with the control group, the frequency and amplitude of slow wave in cathartic colon rats were decreased significantly. Endomorphin 1 and endomorphin 2 significantly decreased the amplitudes of slow wave, but did not change the frequencies of slow wave. The effect of endomorphin 1 was more pronounced than that of endomorphin 2, which could be reversed by the morphine antagonist Naloxone in concentration-dependent manner. Endomorphin could not block the stimulating effect of acetylcholine. Conclusions Endomorphin can influence the colonic electromyography activity and intestine motility of cathartic colon rats, and may be involved in the pathologic mechanism of slow transit constipation.

[Objective] To investigate the clinical significance of approximated molecular subtype.[Methods] Four different subtypes were defined by immunohistochemical (IHC) markers as estrogen receptor (ER),progesterone receptor (PR) and HER2.Clinical characteristics as distribution,age,menopausal status,histopathologic type and grading,tumor size,lymph node status,time to and place of first tumor recurrence were analyzed.[Results] Among all 703 cases,Luminal A was the majority (51.5%) and the least were Luminal B and HER2+.90.8% the patients were less than 59 years old with Luminal A.Different subtype has different histopathologic grading.Luminal A was more than others among grading 1 tumors and it has more T1 tumors,while T4 tumors was most among HER2+ ones.Lymph nodes metastasis has no significant difference between different groups,other than high proportion tendency of N3 stage in Luminal B and HER2+.In addition,Luminal A has the longest time to the first recurrence while HER2+ was the shortest.Moreover,HER2+ and Basal-like have high rates of lung metastasis.Different from foreign reports,the distribution of the first recurrent place and distant metastases have no significant difference.[Conclusion] The classification of breast cancer approximated molecular subtype defined by IHC markers was feasible.The distribution is similar to other countries.Luminal A has rather better clinical characteristics while HER2+ and Basal-like have high rates of lung metastasis.However,Luminal A has the highest proportion of young patients,which is different from other countries.

Objective:To determine the expression of Mcm2(a member of MCMs family) in colorectal neoplasm and to assess the relationship between Mcm2 expression and clinicopathological characteristics of colorectal neoplasm.Methods: Immunohistochemical staining was used to detect the expression of Mcm2 in normal colorectal mucosa(n=23),adenoma(n=33),and cancer(n=69) tissues,and the results were quantified by calculating the labelling index(LI).Results: Mcm2 expression in normal colorectal mucosa was confined to the 1/3-1/2 of colonic crypts basal;there was no expression in coloncytes surface.In colorectal adenoma and cancer,Mcm2 expression was seen throughout epithelium,including the coloncytes surface.The median(range) LI of Mcm2 in these 3 tissues were 18%(5%-37%),35%(15%-75%),66%(41%-90%),respectively.The differences between normal mucosa,adenoma and cancer were statistically significant(P