Objective To explore the effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) operation in the treatment of Pilon type Ⅲ fractures.Methods 54 patients were randomly divided into 2 groups by visiting sequence with random number,odd into the observation group,even into the control group.The observation group(28 cases) received MIPPO operation treatment,the control group(26 cases) was treated with fixed operation.The efficacy was compared between the two groups.Results The excellent and good rate was 85.7％ in the observation group,which was 76.9％ in the control group,there was significant difference between the two groups (Ridit z =12.658,P =0.000).In the observation group,the callus time was (8.1 ± 1.6) w,fracture healing time was (6.5 ± 1.2) m,no refracture occurred; in control group,the callus time was (9.4 ± 2.1) w,the fracture healing time was (7.1 ± 1.1)m,1 case occurred refracture,the differences of callus and bone healing time between the two groups were statistically significant (t =7.865,8.632,all P ＜ 0.05).Conclusion MIPPO operation in the treatment of Pilon type Ⅲ fracture has good effect,MIPPO can be used and promoted in the Pilon type Ⅲ fracture.

Objective To observe the therapeutic effect of Qiliqiangxin capsule combined on refractory heart failure.Methods 60 patients with refractory heart failure were randomly recruited into a control group and a therapeutic group. The control group received the conventional treatment, and the therapeutic group took Qiliqiangxin capsule on the base of the conventional treatment (3 times a day, 4 granules/each time) combined with 120 mg cAMP meglumine. Treatment in both group lasted 14 days. Results: After the treatment, the therapeutic group showed improvement in the symptoms of heart failure. Comparing with the control group, the difference was significant (P＜0.05). Conclusion The therapeutic effect of Qiliqiangxin capsule combined on refractory heart failure is satisfied and can improve the quality obviously.

Objective: To observe the protective effects of Yougui drink(右归饮) on chronic renal failure rats with insufficiency of kidney-Yang(肾阳虚) and investigate its mechanisms.Methods: Chronic(renal) failure model with insufficiency of kidney-Yang was replicated by nephrectomy(5/6 renal cortex) and(propylthiouracil)(PTU) infused into the stomach.The model rats were randomly divided into three(groups:)(model) group,Yougui drink group and sham-operated group.Yougui drink group was given Yougui drink(infused) into stomach daily,while the other two groups were given equivalent water daily for 28 days.The(pathological) study of the kidney tissue was performed and the serum blood urea nitrogen(BUN),creatinine(Cr) and lipid levels were determined after the experiment.Results: Yougui drink significantly decreased serum BUN and Cr levels and increased the reduced triglycerides(TG) in the rats compared to model group(BUN:(13.65?1.37)mmol/L vs.(15.88?1.16) mmol/L,P

Objective To explore the influencing factors during long-distance transportation and medical rescue of trauma patients in Wenchuan earthquake. Methods After Wenchuan earthquake, based on prehospital care scheme, we organized medical coordinators and psychologically trained medical staff in emergency medicine, cardiovascular medicine and logistics to transport trauma patients and pro-vide early psychological intervention during whole course of transportation. Results A total of 162 trauma patients were safely transported from Sichuan province to Chongqing relying on prehospital care scheme, equipment supplies, integrated rescue mode and psychological intervention during the transporta-tion. Conclusions Medical rescue mode and psychological intervention indicate that it is necessary to conduct psychological intervention for better transportation of patients for further medical treatments. In the meantime, we should establish medical rescue system for coping with psychological stress, improve rescue preparation scheme and professional medical care team for long-distance transportation and guaran-tee sufficient medical supplies in station hospitals.

Objective To observe the effect of metformin and exercise therapy for IGT. Methods 86 patients with IGT were given metformin and exercise therapy,the range of glucose,BMI and symptoms improvement were observed before and after the therapy. Results After 6 months therapy,the fasting blood glucose and 2 h after oral administration of 75 g glucose levels were significantly reduced(P＜0.01＝,BMI reduced(P＜0.05＝.72 cases (83.7%)were back to normal glucose tolerance,14 cases maintained IGT(those unable to adhere to exercise and no diet controlled),0 case became DM. Conclusion Metformin and exercise therapy had good efficacy in curing IGT.

BACKGROUND: Primary progressive aphasia is a degenerative disease of nervous system clinically characterized by the progressive decrease of speech ability and the relatively reserved memory. OBJECTIVE: To investigate the characteristics of speech dysfunction and the clinical features of primary progressive aphasia we by reported onel patient with primary progressive aphasia. DESIGN: A case analysis. SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences. PARTICIPANT: One male patient of 56 years old with primary progressive aphasia was selected from the Department of Neurology, Beijing Tiantan Hospital in March 2004, he had got education in senior middle school. The patient had been unable to tell the names of daily living objects at the beginning of 2001. Not only his ability of listening comprehension had gradually declined, but his characters had gradually changed except that his memory had not been affected obviously since 2003. Although he was able in self-care now, he could not normally work. METHODS: ① The spoken fluent types of the patient were evaluated with the standards for the fluency of spoken language in Aphasia battery of Chinese. Western battery aphasia was used to assess the type of aphasia of the patient. Boston diagnostic aphasia examination severity grading standard was applied to grade the severity of aphasia. ② The cognitive psychological tests of visual character-figure matching, denomination for figures and oral reading were used to judge whether the patient had verb-noun dissociation. ③The memory of the patient was assessed with clinical memory scale. MAIN OUTCOME MEASURES: ① spoken fluency, the type and grade of aphasia; ② condition of verb-noun dissociation for the patient; ③ memory of the patient. RESULTS: ① Examination of aphasia: The patient presented the spontaneous talking that named the fluent type, there were wrong meanings in his talks so that he was diagnosed as sensory aphasia. The severity of aphasia was separated into grade 3 levels. ② Cognitive psychological test: The correct rates of verbs and nouns in the test of denomination for figures were 15% and 53% respectively, and there was obvious difference (t=0.231, P ＜ 0.05). ③ Clinical memory scale: The memory quotient was 111,and the clinical memory grade was higher than normal. CONCLUSION: The most outstanding clinical characteristics of patients with primary progressive aphasia is speech dysfunction, and there is verb specific injury.

Objective To summarize the operative experience of transumbilical single-port laparoscopic cholecystectomy. Method The clinical data of 15 patients underwent transumbilical singleport laparoscopic cholecystectomy between May to October in 2010 was reviewed. Results The operative time was 30-85(45±16) min,hospitalization time was (2.5 ± 1.1 ) d. No surgical complications such as bile leak or uncontrolled hemorrhage occurred postoperatively. All the incision were healed well and the surgical scar was virtually concealed whithin the umbilicus. Conclusions Transumbilical single-port laparoscopic cholecystectomy is feasible and safe when patients are well selected. Comparing with conventional laparoscopic cholecystectomy, it's more manipulatively difficult.

Objective To detect the expression of FoxO1 and FoxO3a in liver and muscle tissue from KKAy diabetic mice.Methods Study group consists of 7 KKAy diabetic mice until 12 weeks,thereafter fed high fat diet for 4 weeks.It was diagnosed as diabetes when blood glucose was more than(16.7 mmol/L) in two consequent weeks.Control group consists of 7 C57BL mice 16 week old.Dispatched the mice and took quadriceps of femoris muscle and liver tissue to detect the FoxO1 and FoxO3a protein expression by Western blot with antibody.Results Liver and muscle FoxO1 expression was higher in KKAy diabetic mice than that in C57BL mice.FoxO3a expression was much higher in liver than in muscle in both groups.Muscle FoxO3a expression was higher in KKAy diabetic mice than that in control mice.Conclusion FoxO1 and FoxO3a in liver and muscle expressed differently in diabetic mice and control mice.They may play a role in mechanisms of insulin resistance and type 2 diabetes mellitus.

Objective To detect protein PTEN in live and muscle tissue of KKAy diabetic mice and to investigate whether PTEN is associated with the insulin resistance in diabetic KKAy mice.Methods Animals were divided into normal diet C57BL group(n=7,sixteen-week-old C57BL mice),high fat diet C57BL group(n=7),diabetic KKAy group(n=7),the latter two groups were fed with normal diet until week 12,followed by high fat diet for 4 weeks.Blood glucose was measured every week,it would be diagnosed of diabetes if blood glucose more than 300 mg/dl(16.7 mmol/L) in two consecutive weeks.Dispatched the mice,took quadriceps of femoris muscle and liver tissue,added tissue lytic solution,measured the protein concentration by Bradford method and detect the PTEN protein expression in muscle and liver tissue by Western bolts methods.Results The PTEN protein level was significantly increased in quadriceps muscle and live tissue in KKAy mice as compared to the both age-matched C57BL control groups(P

Objective To investigate the expression of nestin protein and insulin-like growth factor 1(IGF-1) mRNA in rat brain injured by ischemia-reperfusion(I/R),and observe the effects of Tongxinluo,one of Chinese herb drugs,on the expression.Methods The rat model of cerebral I/R injury,reproduced by middle cerebral artery occlusion(MCAO) and release,were divided into three groups: high-dose Tongxinluo group(given 1g/kg?d of Tongxinluo],low-dose Tongxinluo group(given 0.5g/kg?d of Tongxinluo) and control group(administration of saline).2ml of Tongxinluo or saline each time was administered to each rat and 2 times every day up to day 3,5,7,14,21 and 30 after the injury.The expression of nestin in the subventricular zone(SVZ) and hippocampal dentate gyrus zone(DG) was detected by immunohistochemistry,and the IGF-1 mRNA expression around ischemic area was detected by RT-PCR.Results Compared with the control group,the immunofluorescence magnitude of nestin-positive neurons in SVZ and DG was significantly higher in high-and low-dose Tongxinluo groups(P0.05).Conclusions Tongxinluo,a kind of Chinese herb drugs,may promote the proliferation of neural stem cells in SVZ and DG after cerebral I/R injury in rats,and the mechanism may be related to upregulation of IGF-1 mRNA induced by Tongxinluo.