Objective To open the reset common bone and open ordinary osteosynthesis(MIPPO)(in effect in the treatment of high energy tibial fracture.Methods High energy tibial fracture in 42 cases of patients,according to the condition of the patient and the treatment were divided into two groups,using open reduction and bone treatment (open group,22 cases),treated with MIPPO technique(MIPPO group,20 cases).The indicators of operation,postop-erative complications and clinical efficacy of the two groups were observed.Results The operation time,intraopera-tive bleeding volume,fracture healing time of the MIPPO group were (75.2 ±9.7)min,(107.3 ±11.3)mL,(13.1 ± 3)weeks,which of the open group were (73.4 ±10)min,(208.5 ±16.3)mL,(18.2 ±4.7)weeks,the two groups had no statistically significant differences in operative time(P >0.05),two groups of blood loss,fracture healing time, the differences were statistically significant(t =23.153,4.143,all P <0.05);the complication rate in the MIPPO group was 10.0%,tibial shaft fracture healing function excellent rate was 95.0%.The complication rate of the open groupwas healing function excellent rate was 72.7%,36.4% tibial shaft fracture,there were significant differences between the two groups(χ2 =12.316,22.964,all P <0.01).Conclusion MIPPO technology in the treatment of high energy tibial shaft fractures,with less bleeding,fracture healing fast,and the characteristics of a significant effect, which is worth promoting.

OBJECTIVE:To evaluate the analgesic effects and ADR of fentanyl transdermal patches in different therapies. METHODS:189 patients with cancer pain were randomized into three groups:routine dose fentanyl transdermal patches group(group A) ;routine dose fentanyl transdermal patches +12 h controlled-release morphines(Ms) group(group B) ;twice routine dose fentanyl transdermal patches+12 h controlled-release Ms group(group C) . The curative effects of treatment for 6 days in3 groups were compared by VAS method. RESULTS:In group A,B and C,significant differences were noted in curative efficacy(P0.05) . CONCLUSION:The therapy of group C shows better analgesic effect,safety and clinical value than the other two groups.

OBJECTIVE: To compare the economic effects of MS Contin and oxycontin in treatment of cancer pain. METHODS: 120 patients with cancer pain were divided into GroupA1(30 cases),GroupA2 (30 cases),GroupB1 (30 cases) and GroupB2(30 cases). GroupA1 and GroupA2 were received MS Contin via p.o. for 15 days while GroupB1 and GroupB2 oxycontin via p.o. for 15 days. Pharmacoeconomics was applied in costeffectiveness analysis. RESULTS: Effective rates of GroupA1,GroupA2,GroupB1 and GroupB2 were 70.00%,83.33%,96.67% and 90.00%. The costeffectiveness ratios were 385.71,324.01, 284.58 and 305.67,respectively.The incremental costeffectiveness ratios of GroupB1 and GroupB2 were 19.12 and 25.50,respectively as comparing with GroupA1. CONCLUSION: Therapy of GroupB1 is optimal among 4 schemes based on the curative effect or costeffectiveness analysis.

OBJECTIVE:To prepare Koujunmie gargle,establish a quality control method and to observe the therapeutic effect.METHODS:Konjunmie gargle was prepared with method of dissolution;the contents of aciclovir,tinidazole and ciprofloxacin in the gargle were determined with HPLC and the stability test was performed.RESULTS:The method was simple,rapid and accurate.The assay of three ingredients in Koujunmie gargle could be simultaneously performed.The gargle was stable.The total effective rate was99.0%after10-day treatment(P

Objective To discuss the clinical application of rotational DSA and its advantages. Methods 35 cases undergoing cerebral angiography and hepatic arteriography were performed with standard DSA, of which, 24 ones were performed with rotational DSA. Results Standard DSA could only display partial lesion at lateral side, while rotational DSA could display the pathological structure and surrounding structure. Conclusion Rotational DSA is valuable for the diagnosis and treatment of encephalic angioma and liver tumor.

Objective To investigate the prognostic factors of low-and undifferentiated gastric cancer with negative metastasis of lymph nodes.Methods The clinicopathological data of 270 patients with low-and undifferentiated gastric cancer and negative metastasis of lymph nodes who were admitted to the Tianjin Cancer Hospital from January 2002 to December 2007 were retrospectively analyzed.All the patients received radical gastrectomy.One hundred and sixty-one patients had the number of lymph nodes dissected under 15,53 patients had 15-20 lymph nodes dissected,33 had 21-30 lymph nodes dissected and 23 patients with the number of lymph nodes dissected more than 30.Patients were followed up via out-patient examination,phone call and mail till October 2013.The prognosis analysis was done by COX step-wise regression.The survival curve was drawn by KaplanMeier method,and the survival was analyzed using the Log-rank test.Results All the patients were followed up for a median time of 63 months (range,2-103 months).The median survival time was 63 months (range,2-103 months),and the 1-,3-,5-year overall survival rates were 93.0％,69.5％ and 58.5％,respectively.The median survival time of the 161 patients with the number of lymph nodes dissected under 15 was 58 months (range,2-103 months),and the 1-,3-,5-year survival rates were 91.4％,59.3％ and 48.8％,respectively.The median survival time of the 53 patients with the number of lymph nodes dissected between 15 and 20 was 68 months (range,4-95 months),and the 1-,3-,5-year survival rates were 94.3％,84.9％ and 71.7％,respectively.The median survival time of the 33 patients with the number of lymph nodes dissected between 21 and 30 was 68 months (range,34-94 months),and the 1-,3-,5-year survival rates were 100.0％,97.0％ and 87.9％,respectively.The median survival time of the 23 patients with the number of lymph nodes dissected more than 30 was 60 months (range,2-84 months),and the 1-,3-,5-year survival rates were 87.5％,62.5％ and 54.2％,respectively.There was significant difference in the prognosis between the 4 groups (x2 =25.077,P ＜ 0.05).There was significant difference in the prognosis between patients who had 21-30 lymph nodes resected and those had 15-20 lymph nodes resected (x2=3.924,P ＜0.05).Significant difference was also observed in the prognosis between patients who had 15-20 lymph nodes resected and those had more than 30 lymph nodes resected (x2=4.454,P ＜ 0.05),while no significant difference was observed in the prognosis between patients who had lymph nodes resected more than 30 and those had lymph nodes resected less than 15 (x2=0.450,P ＞0.05).The results of univariate analysis showed that gender,age,location and diameter of the tumor,serosal invasion,Borrmann classification,range of gastric resection and the number of lymph nodes dissected were factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes (x2 =4.143,12.607,23.665,11.549,26.350,8.059,5.222,25.077,P ＜0.05).The results of multivariate analysis showed that the tumor diameter longer than 5 cm and serosal invasion were the independent factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes (HR =1.842,3.084,95％ confidence interval:1.286-2.638,1.956-4.861,P ＜ 0.05).Lymph nodes dissected for 21-30 was the protective factor of prognosis (HR =1.533,95％ confidence interval:1.229-2.248,P ＜ 0.05).Conclusions Lymph nodes dissected for 21-30 during radical gastrectomy may improve the long-term survival of patients.The tumor diameter longer than 5 cm,serosal invasion and the number of lymph nodes dissected (less than 15,15-20 and more than 30) were the independent factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes.

Objective:To understand the epidemic characteristics and risk factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhaoyuan City, and to provide basis for the improvement of prevention and control strategies.Methods:Retrospective analysis was performed to collect the SFTS surveillance data and epidemiological investigation results of confirmed cases in Zhaoyuan City from 2011 to 2018 from the "Infectious Disease Report Information Management System of the China Disease Prevention and Control Information System", and the general situation and epidemiological characteristics, onset and treatment, clinical manifestations and contact history of SFTS cases were analyzed by descriptive epidemiology method; 60 cases of SFTS confirmed cases and 120 healthy people in the same village, same sex, and same age group as the confirmed case were selected by case-control study to analyze the risk factors of SFTS.Results:A total of 140 confirmed SFTS cases were reported in Zhaoyuan City from 2011 to 2018, with a fatality rate of 18.57% (27/140); the onset time was mainly from May to August, accounting for 83.57% (117/140); the age of onset was mainly 50 - 80 years old, accounting for 90.00%(126/140); the sex ratio of men to women was 1.06 ∶ 1.00 (72 ∶ 68); the occupation distribution was dominated by farmers, accounting for 92.14% (129/140). In 140 cases of SFTS, the average time intervals from onset to first visit and from first visit to confirmation of diagnosis were 4 and 6 days, respectively; and the average medical visit history from onset to diagnosis was 2 times, 60.71% (85/140) of the cases were first diagnosed by township medical institutions, 86.43% (121/140) of the cases were diagnosed by municipal hospitals; the first symptom was fever, which accounted for 92.86% (130/140). The logistic regression analysis showed that domestic animals [odds ratio ( OR)=9.209, 95% confidence interval ( CI): 2.064-41.083] and tick bites ( OR = 16.818, 95% CI: 1.553 - 182.164) were risk factors for SFTS. Conclusions:The onset time of SFTS is mainly from May to August in Zhaoyuan City, and farmers over 50 years old are the key population; domestic animals and tick bites are the risk factors for the onset of SFTS. The publicity and health education of SFTS prevention and control knowledge for key populations should be strengthened.

ObjectiveTo observe the dynamic change of mtDNA in rats with lung ischemiareperfusion (IR) injury and the implications.MethodsThe rat model of lung IR injury was made.Thirty-two male SD rats were divided into IR group and control group.Each group was sub-divided into two subgroups.Thirty and 60 min after reperfusion,8 rats of each group were sacrificed; left lungs and whole blood were collected.Histopathological study of lung tissues were performed; wet weight/dry (W/D) weight ratio of the lung was detected; DNA was extracted from whole blood,and mtDNA level in circulation was detected by using real-time PCR; the protein levels of MMP-9 and MCP-1were examined by ELISA.Results(1) As compared with control group,the edema and PMN emigration were more serious in IR group; besides,the W/D ratio was increased progressively in IR groups as compared with control groups respectively (P＜0.01); (2) As compared with control group,the mtDNA in circulation was significantly increased 30 min after reperfusion (P＜0.01),and the same trend was detected 60 min after reperfusion (P＜0.01):(3) There was no significant difference between the two groups in the content of MMP-9 and MCP-1in the lungs 30 min after reperfusion (P＞0.05),but the MMP-9 and MCP-1expression levels were increased 60 min after reperfusion (P＜0.01).ConclusionThe mtDNA expression in circulation was increased in the early stage of lung IR,and the increased expression of mtDNA was earlier than the up-regulation of MMP-9 and MCP-1.Our results indicated that mtDNA may aggravate lung injury through increasing MMP-9 and MCP-1in the lung IR.

ObjectiveTo explore the methods and effectiveness of interventional revascularization of complex arteriosclerosis obliterans (ASO)of lower extremity arteries according to their imaging characteristics.Methods Seventy-eight patients with lower extremity ASO complex lesions classified as TASC Ⅱ C/D ( n =68 ) and TASC Ⅱ B ( n =10) underwent antigrade or combined antigrade-retrograde subintimal angioplasty.Their clinical situations were Fontaine stage Ⅲ/Ⅳ or severe stage Ⅱ.All the long occlusion,flush occlusion,multiple occlusion,popliteal artery occlusion,below knee artery occlusion and aortoiliac artery occlusion were identified as complex lesion imaging features and as the indication of interventional treatment if only there were visible outflow vessels and suitable puncture site.Statistical analysis was used to compare ankle-brachial index (ABI) pretreatment and post-treatment by t test.Results Successful revascularization was achieved in 73 patients technically.No obvious complications occurred.Ischemia symptoms improved quickly after accomplishment of recanalization.Average ABI increased from 0.45 ±0.07 to 0.76 ±0.11 after the treatment(t =- 19.78,P ＜0.01 ).Symptoms in 5 patients who failed to get arterial recanalization were stable.Follow up of 6 to 12 months in 47 patients showed stable improvement in 22 of them.Conclusion It is more practical to choose and expand application of interventional treatment for complex ASO according to imaging characteristics of lesions than according to TASC classification.

Objective To summarize the experience of harvesting and using the lungs from donation after citizens death.Method From November 2007 to December 2013,19 cases of potential donation after brain death (DBD) and donation after cardiac death (DCD) were evaluated,including 9 cases of DCD and 10 cases of DBD.All the patients received the tests of sputum culture,bedside bronchoscopes,chest X rays,and blood gas analysis.After clear evaluation,3 cases of DCD and 3 cases of DBD were discharged from the group for bilateral inflammatory infiltration and poor oxygenation index,and the rest one case of DCD was precluded due to long warm ischemic time (＞60 min).The donor lungs from remaining 12 cases were harvested successfully after the declaration of brain death or cardiac death.The donors suitable for the transplant procedure were transported to our transplant center.Result Twelve lung transplants were performed successfully,including 10 cases of bilateral lung transplantation and 2 cases of right single lung transplantation.Two patients was complicated with severe infection and died of sepsis postoperatively,and the remaining 10 patients all recovered uneventfully with dramatic improvement of pulmonary function.During the follow-up period,all the patients lived an active life style with high quality of life.The mean survival time was 34.7 months (4-60 months).Conclusion Lung transplantation using DCD and DBD can be successfully performed after adequate preoperative evaluation of donor lung and abundant preparation for donor harvesting.