[Objective]To introduce the effect of reversed sural neurofasciocutaneous flap with muscle repairing the soft tissue defect of foot and ankle.[Method]Reversed sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect simultaneous open fracture of tibia lower section 6 cases,the soft tissue defect simultaneous chronic osteomyelitis of tibia lower section 5 case,the soft tissue defect of sole of foot simultaneous calcaneus epicarp 3 case, the soft tissue defect of sole of foot simultaneous calcaneus osteomyelitis or dead space 2 case. The scope of the flap was 18 c m?13 cm～11 c m?7 c m and that of the gastrocnemius flap was 4 cm?3 cm～9 c m?6 cm,the thickness was 1～3 cm,the skin flap was bigger than the muscle flap.[Result]Muscle side of the muscle flap was errhysising actively and the skin flap was good circulation duing operation, the muscle flaps were used clinically in 16 patiens all survived completely after operation. All cases were followed up from 5 to 17 months ,incision of open fracture healed primarily, osteomyelitis without reoccurring, the muscle flaps were satisfactory in appearance,feel recovered and walk well.[Conclusion]Reversed sural neurofasciocutaneous flap with muscle has sufficient blood supply and high survival rate,so it is an effective and feasible method in repairing the soft tissue defect of foot, ankle and tibia lower section in special cases.

OBJECTIVE:To establish a method for preparation and quality control of compound dexamethasone liniment.METHODS:The compound dexamethasone liniment were prepared with dexamethasone acetate and vitamin E,the contents were determined by HPLC.RESULTS:The calibration curves of dexamethasone acetate and vitamin E were linear in the range of2～40?g/ml and80～800?g/ml respectively,and their average recoveries were100.5%(RSD=0.82%)and98.6%(RSD=0.59%)respectively.CONCLUSION:The preparation is reasonable in formula,simple and accurate in quality control.

OBJECTIVE:To study the clinical features of adverse drug reactions(ADR)in our hospital.METHODS:A total of 95 ADR cases reports collected in our hospital in 2006 were analyzed statistically and retrospectively.RESULTS:Of the 95 ADR cases,adults aged 19～60a took the lead(52.6%),intravenous drip(51.6%)took the lead,65.3% were caused by antibacterials,lesions of skin and the appendants were the most common manifestations,accounting for 41.1%.CONCLUSION:Great importance should be attached to the monitoring of ADR and publicizing of ADR knowledge to improve rational drug use level.

Objective To investigate the effect of carvedilol combined with spironolactone in the treatment of elderly patients with chronic heart failure clinical efficacy and to provide reference for clinical treatment of formulation. Methods 104 elderly patients with chronic heart failure were randomly divided into observation group and control group,52 cases were randomly divided into observation group and control group.Control group intervention in accord-ance with the conventional treatment of chronic heart failure program,the observation group in the conventional scheme based on,combined with oral carvedilol and spironolactone therapy.6 months after treatment,clinical efficacy was compared between the two groups.The results of echocardiography before and after treatment in two groups were compared.The adverse reactions in the treatment process were compared.Results The effective rate in the observation group was 59.62%,the total effective rate was 96.15%,which were significantly higher than those of the control group (χ2 =4.10,9.82,all P <0.05);After treatment,LVEDD and LVESD of the two groups were significantly lower than those before treatment[(51.89 ±7.06)mm,(41.39 ±6.85)mm,(60.71 ±7.43)mm,(51.02 ±7.95)mm], LVEF[(52.31 ±9.02)% and (41.64 ±7.73)]were significantly higher than that before treatment,there were statistifically significant differences between the two groups(t =4.92,5.10,5.45,2.87,2.98,3.03,all P <0.05);After treatment,LVEDD[(51.89 ±7.06 )mm],LVESD [(41.39 ±6.85 )mm]of the observation group were significantly lower than those of the control group,and LVEF(52.31 ±9.02)% were significantly higher than that of the control group,there were statistifically significant differences between the two groups (t =3.02,2.98,2.97,all P <0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P >0.05).Conclusion Carvedilol combined with spironolactone can significantly improve the clinical effect of the treatment of elderly patients with chronic heart failure,effectively improve the left ventricular remodeling in patients with,improve myocardial contractility in patients and has good security.

To explore the role of CDC25B in pathogenesis and development of colorectal cancer and to investigate the relation between the expression of CDC25B and the clinical pathological character of colorectal cancer and the prognosis of patients. The expression of CDC25B in 168 patients with colorectal cancer and 25 patients with adenoma, and normal colorectal mucosa from 20 individuals was assayed by immunohistochemistry (S-P method). The expression of CDC25B was not detected in adenoma and normal colorectal mucosa. The expression rate of CDC25B in colorectal cancer was 71.4%(120/168). The expression of CDC25B had a positive correlation with distant metastasis and the increase of CEA,while it had no relationship with the tumor stage, grade, lymph node metastases, gender, age or the size of tumor . The patients in whom expression of CDC25B was detected had a markedly low 5-year survival rate. The results suggested that expression of CDC25B in colorectal cancer might accelerate the transformation of cell cycle,which promoted metastasis to distant organ, indicating that the expression of CDC25B might play a role in the development of colorectal cancer. The expression of CDC25B was a risk factor of poor prognosis.

Objective To investigate the expressions of ER? protein and ER? isoform mRNA in sigmoid colon of female slow transit constipation patients. Methods RT-PCR and Western blot were used to detect the expression of ER? protein and ER? isoform mRNA of 20 patients with STC and 20 age-matched controls. Results ER? protein and ER?1, ER?2 and ER?5 mRNA were detected in the two groups lower in STC group than that in control group (P

Objective: To observe the effect of carboxyl-amino-polysaccharide on the gastric ulcer. Methods: Various rat models of gastric ulcer were established respectively by ethanol, aspirin, hydrochloric acid, acetic acid and bound stress in water bath. Results: Inhibitory rates of carboxyl polysaccharide in the dose of 0.5, 0.33, 0.17g/kg were 42.09%, 35.55%and 33.53%for the ethanol-induced model; 53.65%, 49.48%, and 49.76%for the aspirin-induced model; 51.48%, 44.09%, and 33.64%for the hydrochloric-acid-induced model, 49.44%, 46.23%, and 45.10%for the acetic-acid-induced model and 50.12%, 44.63%and 41.92%for the bound-stress-induced model respectively. Conclusion: Carboxyl-amino-polysaccharide can prevent and treat gastric ulcer. Its effect is similar to that of denol, famotidine and cimetidine.

Objective To explore the cell-mediated immune function in patients with colon cancer undergoing minilaparotomy or laparoscopic assisted right hemicolectomy. Methods From January 2009 to August 2014, the colon cancer patients receiving right hemicolectomy were retrospectively analyzed. According to the operation mode, the patients were divided into minilaparotomy group and laparoscopic-assisted group. The clinical and pathological data was analyzed. Cell counts of total CD3, CD4, CD8, CD19 as well as NK cells in venous blood samples were compared between 1 day before surgery and postoperative days (POD) 1 and 5. Measurement data with normal distribution was compared using the t test or Q test. Count data was analyzed usingχ2 test or Fisher exact probability. Results There were 408 patients with colon cancer undergoing right hemicolectomy, 26 patients of whom were excluded. The remaining 382 patients were recruited in the research, which were divided into minilaparotomy group (182 cases) and laparoscopic-assisted group (200 cases). There was no significant difference in the age, gender, body mass index, TNM staging, histological type, blood loss, return of bowel function, tumor location, hospital stay and postoperative complications between the two groups (all P> 0.05). The operating time in minilaparotomy group [(131.53 ± 22.57) min] was shorter than that in laparoscopic-assisted group [(167.53 ± 22.04) min], and there was significant difference (t=15.76, P= 0.00). Compared with prior to surgery, cell numbers of CD3, CD4, CD8, CD19 and NK cells were lower on POD 1 and POD 5 (all P< 0.05), but there was no difference between minilaparotomy group and laparoscopic-assisted group (all P>0.05). Conclusion The minilaparotomy and laparoscopic-assisted right hemicolectomy have same effect on cellular immune function of patients with colon cancer.

This article elaborated the connotation of public hospital medical insurance payment system and the importance of reform,summarizing and analyzing the practical exploration of promoting medical insurance payment system reform in the localities.Then it moved on to introduce new progress of medical insurance payment system reform abroad and the emerging mode of medical insurance payment, such as pay for performance,payment by results,and bundled payment.In the end,the authors put forward policy suggestions to improve medical insurance payment system at public hospitals in China, namely to build a modern healthcare payment system in line with the needs of medical service system.Such a system should be guided by comprehensive performance,restrained by cost budgeting, based on a diversified payment mode,and supported by information technology.In addition,it should have scientific payment standard and modern governance mechanism,and keep interactive development with commercial health insurance.

BACKGROUND: The survival rate of articular chondrocytes is low after traditional cryopreservation,and great differences existed in chondrocytes from surface layer and deep layer,which easily result in graft degeneration and lead to surgery failure.OBJECTIVE: To establish rabbit allograft models of graded frozen articular cartilages with holes made before cryopreservation and to observe the effect of holed cryopreservation on the rabbit articular cartilages.METHODS: Osteochondral plugs taken aseptically from 2 months old rabbits were randomly divided into 3 groups: the experimental group,making holes(3 mm× 3 mm)in articular cartilages and graded freezing; non-hole graded freezing group,non-making holes and graded freezing; cryopreservation group: non-making holes and rapid freezing.The grafts were thawed and transplanted into the relevant articular cartilage defects of recipient rabbits.The grafts differences were observed by gross observation,histochemistry and immunohistochemistry staining.RESULTS AND CONCLUSION: The gross observation,histochemistry and immunohistochemistry staining of the experimental group were superior to the cryopreservation group.Though there were no significant differences between the non-hole graded freezing group and the experimental group,however,the experimental group enhanced the protective effect on cartilage tissue in the middle layer.The graded cryopreservation of articular cartilage gets an advantage over rapid cryopreservation.And the articular cartilage with holes could be preserved successfully in graded cryopreservation,which assures the survival and function of chondrocytes and slows down degrading process of the articular cartilage tissue after thawed and transplanted.