[Objective]Acocording to the effect with different energy grade of extracorporeal shock waves to obtain the better energy of extracorporeal shock waves on treating the nonunion of rabbit radius fracture.[Method]The nonunion model was established in the radius of 32 standard New Zealand white female rabbits,they were' randomly divided into A1,A2,B1 and B2 4 groups.A1 and B1 were the right,A2 and B2 was the left.Treating effect,X-rays film and changs of tissue histology in each experimental groups were observed before and after treament by the shock waves with 0.3,0.4,0.5 and 0.6 mj/mm2 energy to analyze the statistical difference among the each experimental group.[Result]There was a significant difference(P

Objective To understand the career needs of the first session specialist nurses of intensive care unit (ICU) in Jiangxi province and to provide reference for their career management.Methods A qualitative research based on phenomenology was adopted.The first session specialist nurses of ICU in Jiangxi province were enrolled and received in-depth interviews.Results Three themes were found,including career identity needs,career development needs and career management needs.Conclusions Nursing managers should understand the ICU specialist nurses' real feelings and developing career management strategies.

Objective To study the safety of enteral nutrition in preoperative bowel preparation for patients with colorectal carcinoma. Methods 68 patients with colorectal carcinoma were randomized into 2 groups.34 patients in the study group were applied with a kind of enteral nutrition in preoperative bowel preparation.34 patients in the control group were applied with the traditional liquid diet. Results In the study group, the change of the total sum of lymphocytes, hemoglobin, the serum total protein, albumin,prealbumin, transferrin and immune parameters CD3+, CD4+, CD8+ and CD4+/CD8+ after operation had no significant difference compared with that before preoperative bowel preparation (P >0.05). But in the control group, the total sum of lymphocytes, hemoglobin and immune parameters CD+3, CD+4, CD+8 after operation had no significant difference compared with that before preoperative bowel preparation, the serum total protein [(65.35±3.02) g/L],albumin [(32.5±1.98) g/L], prealbumin [(221.02±22.45) mg/L], transferrin [(2.12±0.2) g/L] and CD+4/CD+8 (1.14±1.98) were significantly lower after operation than that before preoperative bowel preparation [(69.43±3.21) g/L, (35.43±2.45) g/L, (236.54±18.45) mg/L, (2.31±0.03) g/L, 1.53±2.45] (P ＜0.05). Conclusion Enteral nutrition could be applied to the preoperation bowel preparation and replace the traditional liquid diet. As a simple way, it can make the colon clear, improve the nutrition and immunity status of the patients.

BACKGROUND:Bone marrow stromal stem cel s have multilineage differentiation capacity and can differentiate into transparent chondrocytes under certain conditions, which can provide new thoughts for treatment of osteoarthritis. OBJECTIVE:To investigate the effects of Tougu Xiaotong Granule containing serum on the cartilage differentiation of bone marrow stromal stem cel s. METHODS:Bone marrow stromal stem cel s from Sprague-Dawley rat limbs were cultured in vitro, and those cel s at passage 3 were used in the study. Cel s were divided into six groups:saline serum group, Tougu Xiaotong Granule water extract group, Tougu Xiaotong Granule alcohol extract group, chondroinductive group, Tougu Xiaotong Granule water extract and chondroinductive group, Tougu Xiaotong Granule alcohol extract and chondroinductive group. The Sox9, col agen Ⅱ, and col agen X mRNA and protein expression levels were tested by real-time polymerase chain reaction and western blot analysis. RESULTS AND CONCLUSION:After cel s were intervened with drug-containing serum for 14 days, the Sox9, col agen Ⅱ, and col agen X mRNA and protein expression in Tougu Xiaotong Granule water extract group, Tougu Xiaotong Granule alcohol extract group, chondroinductive group, Tougu Xiaotong Granule water extract and chondroinductive group, Tougu Xiaotong Granule alcohol extract and chondroinductive group were significantly higher than that in saline serum group (P<0.05, P<0.01). In addition, the chondroinductive group, Tougu Xiaotong Granule water extract serum and chondroinductive group, Tougu Xiaotong Granule alcohol extract and chondroinductive group showed significantly higher expression levels than Tougu Xiaotong Granule water extract serum group, Tougu Xiaotong Granule alcohol extract group (P<0.01). Sox9 expression in Tougu Xiaotong Granule water extract serum and chondroinductive group were significantly higher than that in the chondroinductive group. Experimental findings indicate that, Tougu Xiaotong Granule containing serum can accelerate bone marrow stromal stem cel s differentiate into cartilage cel s by up-regulation of Sox9 expression.

Objective To investigate the diagnosis,the treatment methods and the prognosis of rectal cancer patients after renal transplantation.Methods Four patients with rectal cancer were found in 1035 renal transplantation recipients.Three of four patients were treated with anterior resection (AR) or abdomenoperineal resection (APR) with total mesorectal excision (TME).The two patients accepted regular adjuvant chemotherapy for six months period after surgery,but one patient rejected to accept any chemotherapy after surgery.Otherwise,one patient was only treated with chemotherapy and best support therapy for diagnosed as rectal cancer with multiple liver metastases.Results Two patients were fine to be followed up,8 months and 21 months after rectal resection respectively.Two other patients eventually died of metastasized cancer 5 months and 31 months respectively after therapy had been initiated.Conclusion Transplantation patients should receive standard oncology treatment,including operation and adjuvant treatment,so long as their general condition and organ graft functions allow to do so,although a higher degree of morbidity might be encountered,and periodical colorectal screening should be performed before and after renal transplantation.

Objective To investigate the cause,therapeutic strategy,methods of treatment and clinical results for the rectovaginal fistulas(RVF)after rectal cancer operations.Methods The clinical data of 14 female patients with RVF after rectal cancer operations were examined retrospectively.According to therapeutic strategy,all patients were divided into two groups,A group and B group,which were seperately performed traditional treatment,and progynova in combination with non-operative treatment.Results Among 10 patients in A group,8 patients were performed feacal diversion stoma,and 7 patients with RVF cured naturally,then performued colostomy reversal and restoration of bowel continuity,the other 2 cases were performed non-operative treatment for refusing feacal diversion stoma.Among 4 patients in B group,3 cases with RVF healed naturally during 1.5 to 2 months,one case secondary to rectal anastomosis was performed feacal diversion stoma for rectovaginal fistula without signs of healing.Conclusion RVF is a rare but serious complication after resection of rectal carcinoma,which is taken by the treatment strategy of progynova in combination with non-operative treatment,not only can promote the natural healing of RVF obviously,but also can shorten the healing time greatly.Feacal diversion stoma can be used while the treatment is failure.

OBJECTIVE:To systematically review the effect of ticagrelor versus prasugrel on platelet reactivity,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from PubMed,CJFD and Wanfang Database,randomized con-trolled trials(RCT)about the effect of ticagrelor versus prasugrel on platelet reactivity were collected. Meta-analysis was performed by using Rev Man software after data extract and quality evaluation by Cochrane 5.1.0. RESULTS:Totally 17 RCTs were enrolled,involv-ing 2 757 patients. Results of Meta-analysis showed,regardless of Verity Now(VN)detection method [MD=15.43,95%CI(-0.39, 31.25),P=0.06] or vasodilator stimulus phosphoprotein(VASP)detection method [MD=-3.04,95%CI(-8.98,2.90),P=0.32], ticagrelor and prasugrel had the same effects on platelet reactivity under loading dose,the differences were not statistically significant;regardless of VN detection method [MD=-48.94,95%CI(-58.04,-39.84),P<0.001] or VASP detection method [MD=-14.32, 95%CI(-20.45,-8.20),P<0.001],the effects of ticagrelor were better than prasugrel on platelet reactivity under maintenance dose,the differences were statistically significant. CONCLUSIONS:At the loading dose,there was no difference between ticagrelor and prasugrel,but ticagrelor has more benefits than prasugrel under maintenance dose.

Objective: Vascular dilation dysfunction has been linked with risk of cardiovascular disease. This study was undertaken to investigate the relationship between physical activity and vascular dilation function in healthy middle-aged adults to help explaining the effect of physical activity on preventing cardiovascular disease. Method: We recruited 91 healthy middle-aged adults to complete a serf-report 7-day physical activity recall questionnaire and an exam of brachial artery flow-mediated dilation(FMD) and Nitroglycerin-mediated dilation (NMD) detected by ultrasound. The relationship between physical activity level (PAL) and FMD and NMD were explored. Result: Physical activity showed a significant and positive relationship with the brachial artery FMD, even after adjustment for possible confounding factors (r=0.363, P<0.01). The group of high physical activity level had the highest FMD. The means of FMD (%) in low, moderate and high PAL groups were respectively 8.70%±3.93%,9.01%±3.22% and 12.38±5.67% with significant difference between individuals of low and high PAL and between moderate and high PAL group(P<0.01). The means of NMD (%) is 25.13%±6.52%,24.38%±5.44% and 29.50%±7.25% respectively (P> 0.05) and there was no significant difference among three groups. There was no positive relation between PAL and FMD in premenopausal females but in men and postmenopausal females. Although individuals of high PAL have the best FMD, the moderate PAL can also retard FMD decrease with ageing. Conclusion: Maintaining high physical activity level can enhance endothelial-dependent vascular dilation, and moderate or high physical activity level can prevent endothelial-dependent vaseular dilation declining with aging, which may contribute to decrease risk of cardiovascular disease in healthy middle-aged adults.

Objective To explore the effect of the Eeises setting-up exercises treatment waist back constant pain. Methods Applies the Eeises setting-up exercises treatment to 146 example chronic waist back pain patient,after ache vanishing,continues to earry on the practiee,maintains the treatment result,makes a follow-up visit for 6～12 months. Results Cures rate is 79.45%,shows the effect's rate is 15.07%,rate of ehanges for the better is 4.11%,invalid rate is 1.37%. Conclusion The Eeises setting-up exercises treatment waist back constant pain effect is gcod,facilitates practical,especially suits to be developed in the basic unit hospital.

Objective:To analyze the effect of systematic exercise with a self-designed foot-ankle exerciser on postoperative ankle function in patients with tibial pilon fracture.Methods:A retrospective study was conducted of the 84 patients with tibial pilon fracture who had been treated by open reduction and internal fixation at Nanhua Hospital Affiliated to Nanhua University from May 2018 to January 2020. According to the difference in rehabilitation, they were divided into a control group ( n=42) which were subjected to staged functional rehabilitation after operation and an observation group ( n=42) which was subjected to systematic exercise with a self-designed foot-ankle exerciser. In the control group there was 26 males and 16 females with an age of (36.6±4.8) years (from 20 to 55 years); in the observational group there were 27 males and 15 females with an age of (36.4±4.5) years (from 21 to 57 years). The 2 groups were compared in terms of postoperative recovery, ankle functional recovery, postoperative quality of life, and rate of complications. Results:The 2 groups were comparable due to the insignificant differences in their preoperative general data ( P>0.05). The time for first ambulation [(3.7±0.3) weeks], time for fracture union [(9.1±0.8) weeks], and time for full-weight bearing [(6.5±0.9) weeks] in the observational group were all significantly shorter than those in the control group [(4.1±0.5) weeks, (10.9±1.2) weeks and (7.2±1.1) weeks] ( P<0.05). The good to excellent rate of ankle functional recovery was 92.9% (39/42) for the observational group, significantly higher than that for the control group (73.8%, 31/42) ( P<0.05). The scores for postoperative quality of life in the observational group were significantly higher than those in the control group in dimensions of material, psychology, society and body ( P<0.05). The rate of total postoperative complications in the observational group was 2.4% (1/42), significantly lower than that in the control group (10.9%, 8/42) ( P<0.05). Conclusions:For patients with tibial pilon fracture undergoing the same surgical procedures, systematic exercise with our self-designed foot-ankle exerciser can promote functional recovery of the ankle joint, improve postoperative quality of life, and reduce incidence of postoperative complications.