[Objective]To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures.[Method]Percutaneous reduction and internal fixtion combined with bone graft was performed from April 2004 to April 2006 on 15 cases(16 sides) with intra-articular calcaneal fractures including 13 males (14 feet)and 2 females(2 feet),with average age of 36.6 years(24～61 years).All patients underwent radiography including lateral and axial views for calcaneus,oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification,there were 12 feet of type Ⅱ(three type Ⅱa,three type Ⅱb and eight type Ⅱc)and 2 feet of type Ⅲac. The length of caicaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures.Then bone graft was injected to fill the defect of calcaneus through lateral incision.[Result]All patients were followed up for an average of 18.4 months (ranged,12 to 34 months).No complication such as wound infection,screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society(AOFAS) hindfoot score. The rate of excellent and good clinical results was 100%. Radiography showed basic restoration of Bhler's angle,Gissane's angle and calcaneal shape.[Conclusion]The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders II and III type calcaneal fractures,with advantages of simple operation,fewer complications and good clinical results.

Objective To investigate the decreasing pattern of activities of daily living (ADL) in patients with dementia. Methods A total of 204 patients with dementia were collected,among which 106 cases were with Alzheimer's diseases(AD),54 cases with vascular dementia(VD),44 cases with other types of dementia.According to the scores of mini-mental state examination(MMSE),mild,moderate and severe dementia were 42 cases,37 cases and 125 cases,respectively.All of them were assessed by Barthel index(BI) and compared among degrees of dementia,between AD and VD,and levels of education. Results The most reserved items were bowel movement (48.5 ％),urination (44.1 ％) and grooming (40.2％),while the most vulnerable items were climbing stairs (25.5％) and bathing(18.1％).With increasing impairment of cognition,the scores of BI were getting decreasing. There were significant differences among severe [(23.20 ± 29.27)scores],moderate[(65.54 ± 26.35) scores] and mild [(87.38 ± 22.69) scores] groups (x2 =99.686,P =0.000). Basic ADL were more reserved in AD (16.98％-53.77％) compared with VD (1.85％-33.33％) patients.No significant differences were found(x2 =3.653,P=0.161)among patients with education of primary school and below [(40.1 ± 39.0) scores],middle school[(45.3 ± 39.6 ) scores],and high school and above[(53.1 ± 37.7) scores]. Conclusions Among patients with dementia,bowel control,bladder control and grooming are well reserved,climbing stairs and bathing are vulnerable functions.Basic activities of daily living may be affected by cognitive status and the types of dementia but not levels of culture.

Objective: The influence on the blood glucose,ALB,LYM,K+,Na+,Cl-,TG,TC and so on after the use of different nutrition formula was observed in patients with cerebrovascular disease and type 2 diabetes.Methods: 40 patients who suffered from cerebrovascular diseases and type 2 diabetes were divided into two groups: one group using the ordinary formula and the others using special-purpose formula of diabetes.The levels of blood glucose,ALB,LYM,K+,Na+,Cl-,TG,TC were monitored.Results: The patient's blood glucose after use of ordinary formula rised obviously and insulin or the oral drug for decreasing blood glucose was used.The blood glucose in special-purpose diabetes formula group didn' t increase obviously,and there was not the need of using insulin(P

Objective To observe the effect of silencing P2X7 receptor (P2X7R) by RNA interference on microglial releasing interleukin 1β (IL-1β),tumor necrosis factor-α (TNF-α) and nitric oxide (NO).Methods The small interfering RNA (siRNA) targeting P2X7R gene was observed.The primary microglial cells activated by amyloid-β (Aβ-42) were infected with the lipofectaminesiRNA.The groups were designated as Aβ-1-42,Aβ1-42/siNC,Aβ1-42/siP2X7R and blank control groups according to the different stimulus.After RNA interference for 48 hours,the microglial cells were collected.The survival rate of microglia was detected by CCK-8.The levels of P2X7R mRNA and protein were detected by Real-time PCR and Western blotting respectively.The microglial morphology and the P2X7R immune response were observed by immunocytochemistry staining.Then levels of IL-1β,TNF-α and NO in the supernatantwere measured.Results The Aβ1-42 and siRNA had no effects on the survival rate of microglia.After RNA interference silencing P2X7R,the expression levels of P2X7R mRNA and protein in Aβ1-42/siP2X7R group were decreased significantly,and in this group,the microglial activity and P2X7R immune response were all reduced.In Aβ1-42,Aβ1-42/siNC,Aβ1-42 /siP2X7R and blank control groups,the supernatant levels of IL-1β were (52.54±3.21) μg L,(54.94±2.54) μg/L,(28.70±3.58) μg/L,(24.55±4.34) μg/L,respectively and the supernatant levels of TNF-α were (64.40±4.80) μg/L,(60.94±1.63) μg/L,(25.69±3.13) μg/l,(19.21±1.97)μg/L,respectively.As compared with Aβ1-42 and Aβ-42/siNC groups,the levels of IL 1β and TNF-α in Aβ1-42 /siP2X7R group was decreased significantly (P＜ 0.05),and IL-1β level had no significant difference between Aβ1-42/siP2X7R and blank control groups.The same result was observed in the level of NOin the supernatant.The levels of NO were (1.33±0.19) μmol/L,(4.49±0.28) μmol/L,(4.78±0.33) μmol/L and (1.07±0.36) μmol/L in Aβ1-42/siP2X7R,Aβ1-42,Aβ1-42 /siNC and blank control groups respectively.Conclusions The silencing expression of P2X7 R by RNA interference effectively decreases the levels of IL-1β,TNF-α and NO released by microglia.P2X7 R can be used as an effective therapeutic target for RNA interference treatment of Alzheimer's disease.

Objective To explore the effect of neural stem cells (NSCs) transplantation on neurogenesis in an alzheimer' disease mouse model and its related mechanism.Methods A total of 16 12-month old aPP/PS1 double transgenic aD mice were randomly divided into two groups:NSC group (receiving NSCs transplantation in the bilateral hippocampi,n=8) and PBS group as the negative control group (receiving an equal quantity of 0.01M/L phosphate buffer saline,n=8).another 8 wild type mice without any treatment were selected as the positive control group (Wt group).at five weeks after transplantation,the expressions of doublecortin (DCX) and nestin in the hippocampal dentate gyrus (DG) and subgranular zone (SGZ) were analyzed by immunofluorescence staining,the number of positive cells in these regions were counted by confocal microscopy,and Morris water maze (MWM) test was used to assess cognitive function in all mice.Results NSC group showed the enhanced spatial learning and memory ability in Morris water maze (MWM) as compared to PBS group,but it was still lower than that in Wt mice (both P＜0.05).Immunofluorescence staining showed NSCs induced the increased positive cells expressing DCX and nestin in the NSC group as compared with PBS group (F＝85.400 and 55.687,both P＜0.001).However,the number of DCX positive cells was still lower in NSC group than in Wt group (P＜0.05).There was no significant difference in the number of Nestin-positive cells between the NSC group and the Wt group (P＞ 0.05).Conclusions NSCs transplantation can promote endogenous neurogenesis via the increased expression of DCX-and Nestin positive cells in the hippocampal DG/SGZ in aD mice,which improves the cognitive abilities in aD mice in some extent.

Objective To explore the relationship between the common vascular risk factors and cerebrovascular reserve in the aged patients.Methods 700 patients with sex unlimited were selected from Zhejiang Hospital from July 2007 to July 2010.The clinical data about gender,age,smoking history,drinking history,hypertension,diabetes,dyslipidemia,bilateral carotid artery B ultrasonic examination were collected.The patients were divided into vascular risk factors group(n=400)aged(73.4± 6.8)years and control group(n=300)aged(72.4± 6.9)years.Intracranial vascular reaction was dertermined using transcranial doppler ultrasonography combined with breathholding test to calculate the breath-holding index(BHI)and evaluate cerebrovascular reserve.Results BHI in vascular risk factors group and control group were(0.57±0.18)and(0.97±0.31),respectively,and cerebrovascular reserve in the patients with vascular risk factors was decreased than without risk factors(t =10.87,P ＜ 0.01).Multifactor retrospective analysis showed hypertension,hyperlipidemia,diabetes and smoking were related with cerebrovascular reserve(F=6.51,P =0.000),and the degree to influnce from small to large was followed by diabetes,hypertention,smoking and hyperlipidemia.Conclusions Cerebrovascular reserve is damaged in the aged patients with vascular risk factors.Hypertension,hyperlipidemia,diabetes,smoking may affect cerebrovascular reserves among which the greatest influence is in diabetes.

The microflora plays an important role in providing nutrients to the intestinal mucosal cells.The disruption of the intestinal microflora balance may modify the intestinal barrier function, and influence the health.Dietary fibre can be divided into solububle fibre and insoluable fibre.Insoluable fibre plays an important role in faecal bulking and prevention of constipation.The human body can obtain energy for growth and maintenance of cellular function from fermentation of solable fibre.

BackgroundPosterior capsule opacification(PCO) is the main cause inducing low vision after extacapsular cataract extraction. Our previous study determined that polylysine-ethylene diamine tetraacetic acid (EDTA) (PLE) can suppress the incidence of PCO. ObjectiveThe goal of this experiment was to investigate the inhibition of polylysine-EDTA on rabbit lens epithelial cells (LECs)proliferation in vitro and the effective concentrations of polylysine-EDTA. MethodsThe anterior capsular membranes from 10 3-month-old clean New Zealand white rabbits were digested and then cultured to obtain the LECs. The second and third generation of LECs were inoculated on the 96-hole culture plate with the cell density of the 1 × 105/ml. 12.5,25.0,50. 0,100. 0 μmol/Lof PLE were added into the culture medium for 48 hours respectively,and the DMSO medium was used at the same way as the control group. The proliferation of the LECs was then detected by MTT method and the inhibitory rate of PLE on LECs growth was calculated. ResultsLECs grew at a near normal state in ≤25.0 μmol/L PLE groups,however,cultured LECs were out of shape and the numbers decreased with the weakened adhesion ability in ≥50.0 μ mol/L PLE groups. The A490 values of LECs were 0. 278±0. 013,0. 266±0. 028,0. 260±0. 022 and 0. 247±0. 012 in 12. 5,25.0,50. 0, 100. 0 μmol/L polylysine-EDTA groups respectively and were lower than 0. 311 ±0. 038 of DMSO control group( P=0. 035,0. 011,0. 009,0.013 ). The inhibitory rates of 12. 5,25.0,50. 0, 100.0 μmoL/L PLE on LECs proliferation were 10.61％ , 14.47％ , 16.40％ and 20. 58％ respectively. ConclusionsPolylysine-EDTA can inhibit the growth and proliferation of LECs in vitro at a dose-dependent manner.

The clinical and experimental publish literatures of the traditional acupuncture treatment for xerophthalmia were review and selected, and the acupoints and outcomes index were analyzed. The clinical studies demonstrated that acupoints around eyes, head and face were mainly coordinated with Zangfu organs and meridians; and the experimental studies showed the effect of acupuncture work through stimulation of the lacrimal gland secretion, repairing lacrimal gland structure, inhibition of apoptosis to increase the flow of tears, extending the breakup time of lacrimal film, and relieving eye related symptoms.

OBJECTIVETo compare the efficacy of the patients of xerosis conjunctivitis with liver and kidney yin deficiency among the combined therapy of acupuncture and Shi's manipulation, common acupuncture and artificial tears therapy.

METHODSOne hundred and eight patients were randomized into an acupuncture group, a SHI's manipulation group and an artificial tears group, 36 cases in each group. A total of 15 cases dropped out before the end of the study, including 4 cases in the acupuncture group, 6 cases in the SHI's manipulation group, and 5 cases in the artificial tears group. In the acupuncture group, acupuncture was applied to Jingming (BL 1) and Qiuhou (EX-HN 7) on the affected side, and the bilateral Sanyinjiao (SP 6) and Taixi (KI 3). The needles were retained for 20 min. In the SHI's manipulation group, on the basis of the treatment as the acupuncture group, Shuigou (GV26) was added and stimulated with SHI's acupuncture manipulation. In these two groups, acupuncture was given 3 times a week totally for 3 weeks. In the artificial tears group, sodium hyaluronate eye drops were used, 5 times a day, for 3 weeks totally. Separately, before treatment, at the moment after the 1st treatment and 3 weeks after treatment, the subjective symptom score, Schirmer I test, breakup time (BUT) of tear film were observed in each group.

RESULTS(1) Subjective symptom score: at the moment after the 1st treatment and 3 weeks after treatment, the scores in each group were all reduced significantly as compared with those before treatment (all P < 0.05). At the moment after the 1st treatment, the score in the SHI's manipulation group and the artificial tears group was reduced apparently as compared with that in the acupuncture group (both P < 0.05). In 3 weeks of treatment, the score in the SHI's manipulation group was reduced apparently as compared with the acupuncture group and the artificial tears group (both P < 0.05). (2) For Schirmer I test, at the moment of the 1st treatment, the result in the SHI's manipulation group and the artificial tears group was improved significantly as compared with that before treatment (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group group was improved significantly as compared with that before treatment (both P < 0.05). At the moment of the 1st treatment, the result in the artificial tears group was improved significantly as compared with the acupuncture group and the SHI's manipulation group (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group was better than that in the artifi-cial tears group separately (both P < 0.05). (3) For BUT, the result in the acupuncture group and the SHI's manipulation group was prolonged significantly as compared with that before treatment and was prolonged apparently as compared with that in the artificial tears group (both P < 0.05) in 3 weeks of treatment.

CONCLUSIONThe intervention of SHI's acupuncture manipulation relieves the subjective symptoms of xerosis conjunctivitis of liver and kidney yin deficiency and achieves the same efficacy as the common acupuncture and artificial tears treatment. It does not present the apparent advantages as the common acupuncture in the short term for promoting the tear secretion and tears film repair.

Acupuncture Therapy ; Adolescent ; Adult ; Conjunctivitis ; physiopathology ; therapy ; Dry Eye Syndromes ; physiopathology ; therapy ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Male ; Middle Aged ; Treatment Outcome ; Yin Deficiency ; physiopathology ; therapy ; Young Adult