Objective To observe the clinical outcome of closed reduction and percutaneous screw fixation for talar neck fractures,and explore the minimally invasive treatment for talar neck fractures.Methods From June 2009 to December 2012,12 cases with talar neck fracture were treated by closed reduction and percutaneous screw fixation,including 10 males and 2 females with an average age of 34 years (range,21-52).All cases are unilateral side,including five cases of left foot and seven cases of right foot.All cases are evaluated the displacement,shape and number of fracture fragments by CT before fixing the fracture.According to Hawkins classification:type Ⅰ 7 cases,type Ⅱ 5 cases.Seven patients with type Ⅰ were used direct percutaneous screw fixation,five patients with type Ⅱ were treated with closed reduction and subsequent percutaneous screw fixation.The Computed Tomography was used to evaluate the quality of close reduction.The AOFAS (ankle-hindfoot scale) scores was used to evaluation clinical outcome in follow-up,and Computed Tomography was used to evaluate the result of reduction and fixation after operation.Recording Hawkins sign according to X-ray film,recording infection,talar body necrosis,traumatic arthritis and other complications.Results Twelve patients were followed up for an average of 34 months (range,22-40).At the end of followup,the AOFAS scores was average 90 points (range,84-95).Nine patients showed Hawkins sign 6 to 10 weeks after operation,2 patients did not find Hawkins sign,but in the follow-up period didn't appear talar body necrosis.One case did not appear Hawkins sign,and who's talar body necrosis was diagnosed by MRI,but no collapse,no pain and did not need further treatment.There patients with postoperative subtalar traumatic arthritis,patients are asymptomatic,at end no further treatment.All patients with no wound complications and no neurovascular injury.Conclusion Closed reduction and percutaneous screw fixation for talar neck fractures can obtain excellent clinical results,but should be selecting the appropriate patients,and Computed Tomography must be used to ensure satisfactory reduction.

Objecthe Children's heart valves by Dual-Source Compater Tomography(DS CT)images were enhanced and segmented in order to reconstruct 3D construction of heart valves and make motion analysis based on this model.Method,Adaptive seed-filling algorithm is proposed in this paper to segment interested region of heart based on DS CT images.Contoudet transform is used to enhance and segment heart valve based on the part-segmented image.Result With these methods,DS CT images were SUCCESS fully pro-cessed and segmented in Matlab 7.0 and clear images of mitral valves were got.Condusions The adaptive seed-filling algorithm proposed in this paper and Contourlet transform are very useful for segmentation in dif-ferent situation.The experimental result in this paper proides useful reference for doctors in their research on the motion of mitral valves and planning on surrgical operation of mitTal valves.

Objective To observe the effects of family intervenes on the social function of chronic schizophrenic outpatients in countryside.Methods 150 chronic schizophrenic patient were divided into the intervention group(75 cases)and the control group(75 cases).The intervention group accepted comprehensive family intervention education by the professional,while the control group only accepted the medical intervention.They were assessed with Social Disability Screening Schedule(SDSS),Scale for Assessment of Positive Symptoms(SAPS),Scale for Assessment of Negative Symptoms(SANS),Morningside Rehabilitation Stats Scale(MRSS)before,1 year,2 years and 3 years after intervention.Results The scores of SANS and MRSS improved in the intervention group compared with that of the control group(P<0.001),as well as the ability of self-care,family,responsibility,vocation of SDSS(P<0.05).Conclusion The family intervenes may improve the negative symptom and some social ability of chronic schizophrenic outpatients in countryside.

Normal function of growth hormone-insulin-like growth factor Ⅰaxis is essential for linear growth after birth. A case of continuous growth with undetectable growth hormone level even under insulinhypoglycemia stimulation was reported. The growth hormone deficiency was due to pituitary stalk interruption combined with deficiency of multiple pituitary hormones. Taken together with reviewed literature, this so-called nongrowth hormone-dependent linear growth was preconditioned by other hormones, especially gonadotropin deficiency,and the unclosed epiphysis.

BACKGROUND: Research on mapping the gene for benign familial infantile convulsion(BFIC) has been conducted mainly in western countries. Although three chromosome loci have been found by three research groups, up to now the gene responsible for BFIC has been neither found nor identified. Mapping the gene and studying locus heterogeneity is the first step toward cloning the disease gene.OBJECTIVE: To explore the relation between BFIC loci and the gene for BFIC in five Chinese pedigrees with BFIC. Locus heterogeneity among these pedigrees will be revealed based on the findings so as to further map the gene.DESIGN: Retrospective and observational controlled study using five Chinese pedigrees with BFIC as subjects.SETTING: Laboratory of cell biology and medical genetics in a university.PARTICIPANTS: The study was conducted in the Laboratory of Cell Biology and Medical Genetics of Zhengzhou University from July 2001 to July 2003. Five BFIC pedigrees of 70 subjects, 28 BFIC patients and 42 non-BFIC patients, from Xinxiang, Nanyang, Zhoukou, and Hebi of Henan Province,China, were involved. Inclusion criteria: Those met the epileptic seizure classification criteria issued by the International Anti-epilepsy Commissi6n[2].Exclusion criteria: The patients were excluded from the group of the affected members if any of the three examinations, namely, interictal electroencephalograms, computed-tomography scanning and magnetic-resonance imagining, was abnormal. The same exclusion criteria applied to patients who had suffered either toxicosis or cerebral damage.METHODS: To get the genotypes of these family members, such techniques as polymerase chain reaction, polyacrlamide and agarose gels electrophresis and sliver straining were used. The procedure was as follows: first, DNA was extracted from the peripheral blood of the members of five pedigrees with BFIC. Then, six short tandem repeat(STR) loci, namely, D19S245,D19S250, D16S3131, D16S3133, D2S399 and D2S2330, were used to detect genotype of each family member, followed by input of the genotypes into the computer and linkage analysis by MLINK program from LINKAGE package. Finally, the results of linkage analysis were analyzed by HOMOGM program and locus heterogeneity was obtained.MAIN OUTCOME MEASURES: Analysis results of genotype of each subject and the results of heterogeneity detection.RESULTS: One maximum two-point limit of detection (LOD) score of 2. 151 for D19S250 was obtained at recombination rate of 0. 000 under autosomal dominant model with 90% penetrance. For D16S3131, two maximum two-point LOD scores of 1. 056 and 1. 155 were obtained at recombination rate of 0. 085 under autosomal dominant model with 70% and 60% penetrance. This suggested that the gene for BFIC pedigree might be linked to D16S3131 or D19S250. At the other DNA markers, no information suggested that linkage was produced. The results of heterogeneity detection showed that there was locus heterogeneity among the BFIC pedigrees.CONCLUSION: The gene for BFIC may be linked to D16S3131 or D19S250. Heterogeneity exists in BFIC, which serves as primary information for the further study of mapping the disease gene for BFIC.

Objective To investigate thymidylate synthase on pemetrexed treatment of lung adenocarcinoma effect relationship.Methods The 60 patients with lung adenocarcinoma in our hospital from January 2014 to January 2016 were selected as the research subjects.They were treated with pemetrexed.According to the clinical efficacy,they were divided into the effective group (n =27) and ineffective group (n =33) after 3 courses of treatment.The levels of thymidylate synthase (thymidylate synthase,TS),TS mRNA expression,and the expression of TS protein in the tumor tissues of two groups were analyzed by enzyme-linked immunoadsorbent assay (ELISA),fluorescence quantitative polymerase chain reaction (PCR),and immunohistochemistry.The relationship between TS level and pemetrexed in the treatment of lung adenocarcinoma was investigated.Results The level of ST in peripheral blood of the effective group was significantly lower than ineffective group.The objective response rate and protein of ST gene low expression were significantly higher than high expression of ST.Conclusions The level of thymidylate synthase in patients with adenocarcinoma of the lung is related to the therapeutic effect of pemetrexed in the treatment of adenocarcinoma of the lung.It can be used as a molecular marker to evaluate the clinical efficacy of pemetrexed in the treatment of patients with lung adenocarcinoma.

Objective To study the efficacy of medication management, symptom management and community reentry skills-training modules to prevent rural patients with schizophrenia from relapse and increase their social function.Methods 89 subjects were randomly assigned to the skills training group (45 cases) and the control group (44 cases). Both groups received the same treatments, but the skills training courses were given to the skills training group for twelve weeks when the subjects were addmitted into the trial and at their one-year follow-up timepoint respectively. And a two-year follow-up was carried out. All subjects were evaluated with PANSS, SDSS, relapse and employeement.Results 89 subjects had completed the study. The skills training group demonstrated clinical Results significantly superior to those of the control group on overall improvement according to PANSS and SDSS. Substantially, statistically significant advantages of the skills training group were related to 1) the rate of relapse (11.1% vs 31.8%), 2) the rate of employment (37.8% vs 15.9%).Conclusion Medication management, symptom management and community-re-entry skills-training modules are effective in reducing patients' psychiatric symptoms, preventing them from relapse and increasing their social function.

Background:TLR4 can mediate immune and inflammatory responses,TFF3,MUC2 are the intestinal mucosa protection factor and can maintain the intestinal barrier function. Aims:To investigate the effect of Anchang Yuyang decoction on colon tissue TFF3,MUC2 and TLR4 gene expressions in rats with ulcerative colitis. Methods:TNBS was used to establish ulcerative colitis model in rats. Ninety Wistar rats were randomly divided into normal control group,model group,low,moderate and high dose Anchang Yuyang decoction groups and mesalazine group,and distilled water,different concentrations of Anchang Yuyang decoction and mesalazine were given respectively. All the rats were sacrificed after 21 days. Colonic histopathological score was assessed,and RT-PCR was used to detect gene expressions of colon tissue TFF3, MUC2 and TLR4. Results:Compared with model group,histopathological score and TLR4 expression were significantly decreased in moderate,high dose Anchang Yuyang decoction groups and mesalazine group(P < 0. 05),expressions of TFF3 and MUC2 were significantly increased( P < 0. 05). Compared with moderate dose Anchang Yuyang decoction group,histopathological score in high dose Anchang Yuyang decoction group and mesalazine group was significantly decreased(P < 0. 05),and TFF3 expression was significantly increased( P < 0. 01). Compared with moderate dose Anchang Yuyang decoction group and mesalazine group,MUC2 expression in high dose Anchang Yuyang decoction group was significantly increased(P < 0. 01),and TLR4 expression was significantly decreased( P < 0. 01). Conclusions:Anchang Yuyang decoction can promote the repair of colonic mucosa in rats with ulcerative colitis,and its mechanism may be related to the increase of TFF3 and MUC2 gene expressions and down regulation of TLR4 gene expression.

Objective To identify the influencing factors for rural doctors′ training effect,and suggest on the improvement of such training.Methods On the basis of rural doctors′ survey,the theory of pre-intervention was used to probe into the influencing factors for such training in five dimensions of attention notice,mega-cognitive strategies,advance organizer,goal orientation,and preparatory information.Results 73.2% of the groups were found with satisfying effect.In the single factor analysis,comparison of training effect involving such factors as age,gender,length of work life and pre-intervention revealed statistical significance(P<0.05).As shown in the logistic regression analysis,High motivation in meta-cognitive strategies,Clear goals in goal orientation,Tiered and categorized training in advance organizers,and Practical learning in preparatory information,as well as variants like age would influence rural doctors′ training effect significantly.Conclusions The key to better training effect lies in better motivation of the trainee,setting correct training goals,emphasis on the practicability of training contents and,the pertinence of the training objects.

Interventional bronchoscopy is widely used in histopathological diagnosis of airway disorders.Hemorrhage is the most frequently encountered and difficult-to-manage complication during bronchoscopy,and massive hemorrhage could be life-threatening.There were differences in the incidence of hemorrhage caused by different interventional procedures.At present,the prevention of bleeding induced by intervention is relatively lacking,and the choice of treatment may be not the same in different endoscopy centers.We review the prevention and treatment of hemorrhage complicated by interventional bronchoscopy in this article,which may help to improve the understanding and management ability of hemorrhage during bronchoscopy.