[Objective]To introduce a new technique of ankle arthrodesis with trephine by lateral approach and evaluate its clinical effects.[Method]Ankle arthrodesis with trephine was performed in 20 patients with serious lesions.Lateral incision was adopted and osteotomy of fibula facilitated the exposure of the fusion site.A trephine of appropriate diameter was used for bi-osteotomy,thus inside the trephine gaining two bone blocks were then rotated 90? and replanted in situ.The pruned fibula was fixed with screws as on-lay!grafting.Proper cast was utilized postoperatively to maintain a functional position.[Result]The average follow-up period was 26 months(ranged from 6 months to 4 years).All the wounds healed well at 2 weeks and the callus appeared 4 weeks postoperatively.Sufficient pain relief was obtained in all patients at 12 weeks and appearance improved greatly.A solid union was achieved in all cases through the radiograph.[Conclusion]The use of trephine in ankle fusion by lateral approach is proved to be a simple technique with high union rate.The main advantages of the technique over other methods of arthrodesis include: excellent exposure by regular incision;less disturbance of the original joint,thereby preserving normal height of the joint and length of the extremity;no need for extra graft through in-situ grafting of the bone blocks and rigid on-lay grafting of lateral malleolus for high primary stability.

Radiotherapy is the primary treatment for nasopharyngeal carcinoma, and the disease control rate and survival time are able to be greatly improved by enhancing the radiosensitivity. Via mechanisms such as binding to target genes mRNA 3'untranslated region (3'UTR), microRNA (miRNA) inhibits translation, which therefore regulates transcription of target genes and thus affect target protein expression. Recent research showed that miRNAs play significant roles in improvement of radiosensitivity in nasopharyngeal carcinoma. This article reviews mechanism of miRNA action to strengthen radiosensitivity of nasopharyngeal carcinoma and the future of clinical practice of miRNA in this disease.
3' Untranslated Regions ; Carcinoma ; Humans ; MicroRNAs ; pharmacology ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; RNA, Messenger ; Radiation Tolerance ; Radiation-Sensitizing Agents

Objective To investigate antimicrobial use in 33 township central hospitals,and improve the rational use of antimicrobial agents. Methods Thirty-three township central hospitals in 1 1 counties were randomly select-ed,7 920 outpatient prescriptions,medical records of 465 non-surgery patients and 213 surgery patients were inves-tigated and analyzed. Results Of 33 hospitals,antimicrobial usage rate in outpatients and inpatients was 56.60%and 89.68% respectively,combined antimicrobial usage rate was 24.16% and 43.58% respectively. Antimicrobial use density in inpatients was 147.25DDDs. Antimicrobial usage rate in surgery patients was 97.18% ,combined an-timicrobial usage rate was 59.90% ,the percentage of one drug,two-drug combination and three-drug combination was 40.10% ,47.82% ,and 12.08% respectively. The percentage of antimicrobial use in patients of type Ⅰ,Ⅱ, and Ⅲincision was 97.56% (40/41),96.93% (158/163)and 100.00% (9/9)respectively,combined antimicrobial us-age rate was 30.00% ,67.72% ,and 44.44% respectively.Conclusion The overuse of antimicrobial agents exists in 33 township central hospitals,antimicrobial usage rate,combined usage rate,antimicrobial use density and antimi-crobial prophylaxis in typeⅠincision operations are all high.

Agenesis of Corpus Callosum ; Chromosomes, Human, X ; Gene Deletion ; Glycerol Kinase ; genetics ; Humans ; Infant ; Male ; Syndrome

Objective To compare efficacy of two intensive therapies:continuous subcutaneous insulin infusion(CSⅡ) and multiple subcutaneous insulin infusion (MSⅡ) for treatment of type 2 diabetes mellitus.Methods 60 patients with type 2 diabetes mellitus were randomly divided into 2 groups. Patients in CSⅡ group were treated by insulin (Novolin R) through a infusion pump. Patients in MSⅡ group were treated by Novolin R before meals (3 times a day) and Novolin N at bedtime. Blood glucose was monitored the whole day before and after treatment. Time required for blood glucose to reach the standard level, insulin dosage and hypoglycemia incidence were compared between the 2 groups before and after treatment. Results Both of the 2 therapeutic methods effectively controlled blood glucose (P＜0.05). However, the 2 groups had significant difference in terms of the time required for blood glucose to reach the standard level ( 3.6 ± 1.2 d vs. 9.4 ± 3.2 d, P ＜ 0. 01 ), daily insulin consumption (35.2 ± 8.5 u vs. 43.2 ± 10. 1 u, P ＜0. 01 ) and hypoglycemia incidence (2. 1% vs.9.7%, P ＜0.01 ). Conclusions CSⅡ and MSⅡ are effective for treatment of type 2 diabetes mellitus. CSⅡ is superior to MSⅡ due to its advantages of quick response, safety, and less insulin consumption.

Aspergillosis, Allergic Bronchopulmonary ; diagnosis ; drug therapy ; Child ; Humans ; Male

Objective To analyze the methylation status and protein expression of Ras association domain family- 1A (RASSF1A) in endometriosis (EMS). Methods The ectopic and corresponding eutopic endometrium tissues were collected from 45 women with EMS and normal endometrium tissues of 20 women without EMS. The methylation status of RASSF1A was examined by methylation specific PCR (MSP). Immunohistochemistry was performed to measure the level of RASSF1A in endometrium tissues. Results The RASSF1A protein expression rate in ectopic endometrium, eutopic endometrium, and normal endometrium was 37.78%(17/45), 60.00%(27/45) and 85.00%(17/20), and there was significant difference (χ2 = 13.136, P = 0.001). The frequency of aberrant methylation of RASSF1A was 55.56%(25/45), 33.33%(15/45) and 0 in ectopic endometrium , eutopic endometrium, and normal endometrium, and there was significant difference (χ2 =18.770, P = 0.000). The frequency of aberrant methylation of RASSF1A had no significant differnce throughout the menstrual cycle in ectopic endometrium and eutopic endometrium: 66.67%(14/21) vs. 45.83%(11/24), 38.10%(8/21) vs. 29.17%(7/24), P>0.05. In ectopic endometrium, the frequency of aberrant methylation of RASSF1A inⅢ-Ⅲstage was significantly higher than that in Ⅰ-Ⅱstage (χ2=5.940, P=0.015). In ectopic endometrium and eutopic endometrium, the RASSF1A protein expression had negative correlation with aberrant methylation of RASSF1A (r =- 0.594、- 0.577, P<0.01). Conclusions Epigenetic inactivation of RASSF1A through aberrant promoter methylation may be strongly correlated with the formation and progression of EMS, and assessment of RASSF1A methylation status in eutopic endometrium may be a potentially useful biomarker to enhance the early detection of EMS.

Background:Gastric cancer(GC)is the fourth commonly seen cancer in the world. The role of Notch signaling pathway in the pathogenesis of tumors has become a focus in related studies,however,the underlying mechanism of Notch1 in GC has not yet been fully understood. Aims:To investigate the expression and significance of Notch1 in human GC tissue. Methods:A total of 115 patients with GC admitted at Jiaxing First Hospital from October 2011 to July 2014 were enrolled. Expression of Notch1 in cancerous tissue and para-cancer noncancerous tissue was determined by immunohistochemistry. The correlation between expression of Notch1 and clinicopathological characteristics of GC was analyzed. Results:Expression rate of Notch1 in cancerous tissue was significantly higher than that in para-cancer noncancerous tissue(73. 9% vs. 3. 5% ,P < 0. 001). Notch1 expression in cancerous tissue was significantly correlated with depth of vascular involvement,lymph node metastasis and TNM stage of GC(P < 0. 05). Conclusions:Notch1 as a cancer-promoting gene is involved in the pathogenesis of GC,and has a close association with tumor invasion and metastasis.

Since intra-arterial chemotherapy with the help of implantation of port-catheter system (PCS) was first used in the surgical field in 1981, PCS has been widely employed in the field of interventional radiology. Intra-arterial chemotherapy by implantation of PCS has some certain advantages such as minimal invasion, no need of general anesthesia, etc. Ten randomized clinic trails have been already reported, which indicate that intra- arterial chemotherapy with PCS is obviously superior to systemic chemotherapy in treating hepatic metastasis form colorectal cancer. As for the treatment of advanced biliary tract cancer, pancreatic carcinoma and hepatocellular carcinoma, the relevant reports can be found only in several phaseⅠ/Ⅱclinical trials or in some retrospective cohort studies. This paper aims to make a comprehensive review about the indications, clinical applications and complications of PCS in treating abdominal tumors in order to improve the clinical practice.

Purpose To implement lower artery angiography in patients with peripheral arterial occlusive disease, and to investigate the feasibility of lower extremity gemstone spectral CT angiography in improving image quality.Materials and Methods Forty-eight patients suspected with lower extremity arterial occlusive diseases were randomly divided into research group and control group. Research group (24 cases) were carried out gemstone spectral CT angiography (CTA) scan and control group (24 cases) were scanned with multi-slice spiral CT (CTA). The CT value of the common iliac artery, popliteal artery and its branches was measured and contrast to noise ratio (CNR) were calculated in both groups. The images were evaluated independently by 2 senior physicians based on a 5-level evaluation standard.Results The CT value of common iliac artery, popliteal artery, anterior tibial artery and the CNR in research group were all higher than those in control group (t=8.7, 7.9, 12.6 and 17.2,P<0.01), but the background noise was lower than that in control group (t=1.5,P<0.01). The scores of two image quality accessed by physician 1 and 2 were 110:90 and 111:93 respectively with statistical difference (Z=-7.6 and-8.0, P<0.01).Conclusion The image obtained by gemstone spectral CT optimal single energy image technique is much better than that by conventional multi-slice spiral CT in lower extremity angiography.