ObjectiveTo investigate the curative effect of structural bone graft in treatment of high energy injury-induced complicated distal radius fractures combined with articular surface collapse and comminuted epiphyseal bone defect.MethodsThe study involved 38 patients with distal radius fractures (AO classification, type C3) treated from January 2007 to October 2010.The patients were treated with temporary Kirschner wire fixation to recover the wrist articular surface, distal radius length and palmar tilt angle at the greatest possibility.According to the form of the bone defects, the iliac bone taken from three layers of the cortical bone was embedded in the subchondral bone to support the bone graft, and a small amount of cancellous bone graft was collected to fill the articular surface collapse as much as possible for anatomical reduction of the articular surface, and anatomical form of the distal radius was reconstructed.Modified Sarmiento Gartland and Werley evaluation systems were used to evaluate the articular function recovery.ResultsThe follow-up lasted for 1-3.2 years, which showed no complications such as plate rupture or iatrogenic nerve blood vessels injuries.The fracture healing time was 15-22 weeks (mean 18.3 weeks).The wrist articular function in some patients obtained obvious improvement through functional rehabilitation training.According to the modified Gartland and Werley function evaluation systems, the curative effects reached excellence rate of 87％.During follow-up, there were two patients with high progressive loss in the height of the distal radius and two with articular surface collapse and severe carpal joint flexion and extension dysfunction.ConclusionsThe high energy injury-induced distal radius fractures with articular surface collapse and epiphyseal bone defect need recovery of the wrist articular surface, distal radius length and palmar tilt angle.Structural bone graft can effectively support the grafted bone and maintain the flatness of the radiocarpal articular surface, restore the anatomy of the distal radius and facilitate the functional recovery of the wrist.

Objective: From the point of clinic application,this article introduces the design and application of optometry glasses NL-Ⅱ. Methods: The new model optometry glasses NL-Ⅱwas compared with the old ones. Results: Optometry glasses NL-Ⅱhave many advantages in both function and layout. Conclusion: Optometry glasses NL-Ⅱ can and have been used in hospital very well,but it need some improvements to make the glasses more helpful in clinic.

This article introduces the design and application of multifunctional optometry glasses.Comparing with the old ones,multifunctional optometry glasses has many advantages in both function and layout.At last,some improving ideas are put forward to make the glasses more helpful.

We applied bilingual teaching in internal medicine for students in our school from 2003 in order to cultivate medical students of high quality and to improve their ability in using professional foreign language.We analyzed our experiences from the aspects of teaching object,selection of teachers and teaching methods and summarized some problems during the process.We got the conclusions that only through strengthening bilingual teaching materials compiling,training young teachers and adopting diversified bilingual teaching means,can we achieve better bilingual teaching effect.

Objective To investigate the possibility of the involvement of RhoA/mDia1 pathway to cause the expression of phosphorylate ezrin-radixin-moesin (p-ERM) in rat pulmonary micro-vascular endothelial cell (PMVEC) after the stimulation of lipopolysaccharide (LPS).Methods The specimens of lung tissue were taken from healthy male SPF grade SD rat with 100-120 g body weight which was purchased from the laboratory animal center of Anhui province.After culture,the PMVECs were randomly divided into dose-dependent groups (0,0.1,1,10 μg/mL LPS added in PMVECs and cultured for30 min,n =8 in each),time-dependent groups (10 μg/mL LPS added to PMVECs cultured for 0,15,30,60,120 min,n =8 in each) and intervention group (n =8).In the intervention group,PMVECs were cultured with 1 μg/mL C3 transferase in serum free media for 240 min,followed by treatment with 10 μg/mL LPS for 30 min.Meanwhile,two control groups in serum-free DMEM medium were made by adding 10.μg/mL LPS to PMVECs and 1 μg/mL C3 transferase to PMVECs respectively cultured for 30 min (n =8 in each).Western blot was used to detect the level of p-ERM,ERM and mDia1.Data were analyzed with SPSS 16.0 software,while one way analysis of variance (ANOVA) was used to compare multiple sets of variables,the intergroup comparisons were analyzed by the least-significant-difference (LSD) tests,with P ＜0.05 for the statistically significant difference.Results ERM,p-ERM and mDia1 were presented in rat PMVEC.Stimulation with LPS up-regulated p-ERM,mDia1 in a dose-dependent manner:LPS [0 μg/mL LPS group:(0.520±0.101),0.1 μg/mL LPS group:(0.657 ±0.092),1 μg/mL LPS group:(0.891 ±0.167),10 μg/mL LPS group:(1.227 ±0.106);0 μg/mL group vs.0.1 μg/mL group,P ＞0.05;the rest P ＜0.01];and mDia1 [0 μg/mL LPS group:(0.200 ±0.102),0.1 μg/mL LPS group:(0.430 ±0.121),1 μg/mL LPS group:(0.603 ±0.154),10 μg/mL LPS group:(0.887 ±0.204);0.1 μg/mL group vs.1 μg/mL group,P ＞ 0.05;the rest P ＜ 0.05].In time-dependent group,the level of p-ERM protein increased at 15 min (0.670 ±0.149),peaked at 30 min (1.175 ±0.103),then decreased,at 60 min (0.959 ±0.189),90 min (0.842 ±0.129),but kept at higher level at 120 min (0.767 ±0.097) than that in control group (0.471 ±0.157,15 min group vs.120 min group,60 min group vs.90 min group and 90 min group vs.120 min group,P ＞ 0.05;the rest P ＜ 0.05);and the level of mDia1 increased at 15 min (0.779 ±0.035),peaked at 30 min (0.889 ±0.036) then decreased at 60 min (0.648 ±0.019),90 min (0.582 ±0.068),but kept at higher level at 120 min (0.526 ±0.059) than that in control group (0.284±0.118,all P ＜ 0.01).C3 transferase caused a marked attenuation of LPS induced p-ERM expression [control group:(0.339 ± 0.069);C3 + LPS group:(0.438 ± 0.07);C3 control group:(0.352 ± 0.071);LPS control group:(0.634 ± 0.191),C3 + LPS group vs.LPS control group,P =0.01],as the same in mDia1 [control group:(0.449 ±0.122);C3 + LPS group:(0.380 ±0.148);C3 control group:(0.404 ±0.164);LPS control group:(0.622 ±0.174),C3 + LPS group vs.LPS control group,P ＜ 0.01].Conclusions LPS could up-regulated the expression of p-ERM protein,and inhibition of RhoA/mDia1 signal pathway by C3 transferase could down-regulated the p-ERM levels.

Objective:To explore the clinical value of remote ECG consultation for primary medical institutions. Methods:Remote ECG consultation data for medical institutions of different levels in Hubei Jianli county were sta-tistically analyzed.Results:In county hospitals of this area,there were 1334 cases of ECG consultation,the positive rate was 41.00% (547/1334),and the three abnormal ECG types with highest incidence rate were arrhythmia (27.29%),left ventricular hypertrophy (LVH,9.15%)and ST-T change (2.62%)in order;in rural health rooms of this area,there were 723 cases of ECG consultation,the positive rate was 55.19%(399/723),and the three ab-normal ECG types with highest incidence rate were arrhythmia (34.02%),ST-T change (11.07%)and LVH (5.39%)in order.Conclusion:The remote ECG consultation is easy to perform.It can rise the detection rate of transient abnormal ECG events in rural area,where is lack of ECG equipment and personnel,so it is worthy of ex-tending.

OBJECTIVE To evaluate the curative effect of acute cerebral stroke influenced by lower respiratory tract infection. METHODS To adopt previous way to compare one group included 178 cases with lower respiratory tract infection with the other group included 172 cases which had not been infected,and the relationship between the contact of lower respiratory tract infection and curative effect of acute cerebral stroke. RESULTS The neural function defects′score of the infected group was higher than the noninfected group(P

Objective:To investigate the expression of CXCL12-CXCR4 and VEGF-C in pancreatic cancer and relation to clinical pathology.Methods:The tissue samples including PAC,the cancerous peripheral tissues,the normal pancreatic tissues and peripheral lympho nodes were obtained from 30 patients with PAC.The expressions of CXCL12,CXCR4and VEGF-C proteins in these tissues were assayed by immunohistochemical staining.The expressions of CXCL12,CXCR4 and VEGF-C mRNA in PAC were also investigated by fluorescence quantitative real-time PCR.Results:In all the samples,the positive rates of CXCL12 protein in PAC,the cancerous peripheral tissues,the normal pancreatic tissues and peripheral lympho nodes were respectively 13.3%(4/30),46.7%(14/30),56.7%(17/30) and 50.0%(15/30).The positive rates of CXCR4 protein in PAC,the cancerous peripheral tissues,the normal pancreatic tissues and peripheral lympho nodes were respectively 80.0%(24/30),70.0%(21/30),26.7%(8/30) and 73.3%(22/30).The expression levels of CXCR4 mRNA in PAC tissues,the cancerous peripheral tissues and peripheral lympho nodes were higher than that in the normal pancreatic tissues(P

Objective To study the mechanism of pulmonary injury and protective effect of modified ultrafiltration on lung function in infant open heart surgery.Methods According to the wishes of parents,40 cases of congenital heart disease were divided into without modified ultrafiltration control group (C) and modified ultrafiltration group (M),and parents signed informed consent.The cardiopulmonary bypass (CPB) was used without ultrafiltration in Group C,while with modified ultrafiltration in group M.The pneumodynamic parameters and C3a,C5a,TXA2,LT were measured at specific time points.Results The static pulmonary compliance (Cstat) and oxygen index (OI) were lower,and alveolar-arteria oxygen difference (AaDO2) was higher after CPB in the two groups(P ＜ 0.05).At T3,T4 and T5 time points,the Cstat and OI in Group M was higher than that in Group C; AaDO2 in Group M was lower than that in Group C (P ＜0.05).The levels of C3a and C5a were lower after CPB in the two groups; levels of TXA2,LT were higher after CPB in the C groups.At T2,T3,T4 and T5 time points,the TXA2 and LT in Group M were lower than that in Group C(P ＜0.05).Conclusions The pulmonary injury in pediatric open heart surgery may be concerned with the the alexin(C3a,C5a) activation and I/R.The level of C3a and C5a was considered earlier index of inflammatory reaction and pulmonary injury.Modified ultrafiltration improves pulmonary function due to elevating coloid osmotic pressure and degrading the plasma level of TXA2,LT.

Objective To increase the understanding in protein-losing enteropathy (PLE).Methods Sixty-one PLE patients were enrolled in the study and the clinical characteristics, complicated disease, diagnosis and treatment were analyzed. Results The age of the patients was 16-77 (40±15)years, and the gender ratio was 35:26 (female: male). The main clinical manifestations were bilateral lower limb edema in 51 cases, ascites in 41 cases, bilateral pleural effusion in 23 cases, pericardial effusion in 13cases, abdominal pain in 16 cases and diarrhea in 33 cases. The prominent abnormality in laboratory examinations was hypoalbuminemia. The underlying diseases include systemic lupus erythematosus (SLE) in 28 cases, intestinal lymphangiectasia in 12 cases, hepatic cirrhosis in 5 cases, heart diseases in 5 cases,Crohn's disease in 3 cases, membranous nephropathy in 2 cases, Budd-Chiari syndrome in 1 case. Four cases happened after abdominal operation and 1 case after radiation therapy of gastric cardia cancer. Thirtyseven cases were diagnosed by 99Tcm-labelled human serum albumin scintigraphy and 24 cases were diagnosed clinically. Treatment was focused on underlying diseases. The clinical manifestations in 21 cases of SLE improved after SLE was controlled. In 2 cases of intestinal lymphangiectasia and one with Crohn's disease, the clinical manifestations improved after surgery. The other patients had no improvement.Conclusions PLE was not uncommon in clinical practice. Its predominant characteristics were severe hypoalbuminemia, edema and dropsy of serous cavity. PLE can complicate other diseases such as SLE,intestinal lymphangiectasia. Treatment should be focused on primary disease.