Objective To explore the best procurement technology for cadaveric donor nephrectomy. Methods Clinical data of 1 439 donors nephrectomy in the past 24 years were retrospected.Bilateral nephrectomy,en bloc removal of both kidneys and en bloc removal with in situ cooling both kidneys were adopted in different periods of time.Operation time(OT),hot ischemia time(HIT),cold ischemia time(CIT),total ischemia time(TIT), renal graft beginning to produce urine time after revascularization(UT),renal function recovery time(RRT), damage rate(DR),quantity of preservation solution(PS), rate of acute tubular necrosis(ATN),primary non function(PNF) and poor perfusion of donor kidney(PPK) were observed and comparad among the 3 techniques. Results 216 cases were accomplished by bilateral nephrectomy and 432 kidneys were procured.1 134 cases were accomplished by en bloc removal and 2 264 kidneys were procured(4 cases had only one kidney each).Eighty nine cases were accomplished by en bloc removal with in situ cooling and 178 kidneys were procured. HIT of these three techniques (bilateral nephrectomy,en bloc removal and en bloc removal with in situ cooling) were 8.22?3.01min?5.35?1.88min?1.89?0.92min ( P 0.05).UT were ( 28.24 ?10.65)min,(22.72?8.35)min,(9.26? 10.95 )min.RRT were (9.98?6.84)d,( 7.59 ?6.35)d,(4.91? 7.68 )d.ATN were 15.40%,7.31%,3.98%( P

Objective To explore the effects of leukocyte in the injured foci on brain edema after brain contusion,in order to provide theoretical basis of clincial treatment of traumatic brain injury.Methods Traumatic brain injured animal model was established with injecton of blood components,forty five rats were randomly divided into three groups i.e,traumatic brain injure (TBI) group,whole blood(WB)group and white blood cell(WBC) group.Each group was further divided into three subgroups.All rats were killed at 24, 72 or 120 hours after injury,the water content, sodium, potassium and calcium contents were measured in brain tissue of areas injured.Results There was a peak of brain water and sodium contents in TBI, WB and WBC groups at 3 days after injury;Brain water content of TBI group was significantly lower than both WB group and WBC group (P

Objective To explore methods to develop a hospital quality of care index system of county level hospitals based on the homepage of inpatient medical records and examine the validity of this system. Methods By means of literature review, homepage data and panel discussion, along with theories and statistical methods, indexes were identified. The dimensions and indices of the index system were pinpointed. Confirmatory factor analysis and normalization methods were combined to calculate the weights and scores of such indices. Scores were adjusted by Charlson comorbidity index ( CCI) with multi-regression method. The hospitals were ranked by adjusted scores in each dimension. The validity was evaluated by comparing the application results to universally acknowledged standards, such as hospital level and economic level of the geographic areas. Results An index system with 6 dimensions and 25 indices was developed, and the application results proved valid to some extent. The adjustment of CCI also proved effective. The 6 dimensions were correlated yet their directions were not consistent. Conclusions The methods and data used to develop the system have demonstrated strong operability and availability. The application results can reflect medical care quality in different aspects making it applicable among homogeneous hospitals. It is meaningful to assess dimensions respectively.

cerebral infarction as compare with patients at Grade 1-2 in both vascular locations, whereas the risk was not significantly increased in patients at Grade 3-4 in only one vascular location. Conclusions The simple method of assessing the degree of arterial atherosclerosis can be used to evaluate carotid artery and lower-extremity artery atherosclerosis in patients with type 2 diabetes. Patients with plaques or stenosis in both vascular locations were with a significantly increased risk of coronary heart disease or cerebral infarction if they were evaluated concurrently.

[Summary] Data from 1 589 consecutive inpatients with type 2 diabetes mellitus from January 2012 to March 2015 were collected. The patients were divided into five groups according to the quintile of HbA1C . The association between serum uric acid ( SUA) and HbA1C was tested using a general linear model after adjusting for age, body mass index ( BMI) , systolic blood pressure, and creatinine. Linear regression analysis was used to analyze the association between SUA and HbA1C in patients with HbA1C<9. 0% and HbA1C≥9. 0%, respectively. The results showed that BMI, waist circumference, triglycerides, and the incidence of fatty liver were elevated with increased serum uric acid level. SUA was negatively associated with HbA1C level in inpatients with type 2 diabetes. However, SUA should be measured after glycemic control in men with HbA1C≥7. 0% and women with HbA1C≥9. 0%.

OBJECTIVETo design a kind of internal fixation device to treat the syndesmosis injury.

METHODSThe elastic syndesmosis hook plate is made of medical stainless steel alloy, which is consisted of locking or common screw fixing hole of the tibial side for the head, tridentate fork like arc anatomical fibula side plate for the tail and serpentine elastic connecting body. By reduction of the joint of the lower tibia and fibula, the steel plate tail is fixed at the side of the fibula and the head is fixed at the side of the tibia for fixing the symphysis.

RESULTSThe design of elastic syndesmosis hook plate is reasonable, and the operation is convenient. There is no need to penetrate the substantia ossea and the plate has elastic micro-movement feature, the problem of internal fixation breakage and loosening is avoid in huge degree, so it is safe and reliable.

CONCLUSIONThe elastic syndesmosis hook plate is a new type medical apparatus of internal fixation of the symphysis, which is worthy of clinical popularization and application.

We described an elderly female with type 2 diabetes referred to our hospital with fever,nausea and upper abdominal pain.The patient had got duodenal tumor and received the pancreaticoduodenectomy (PD) 12 years ago.The laboratory examinations revealed white blood cells (WBC) increasing and severe hypocalcemia.Abdominal computed tomography (CT) revealed a huge gas-forming pyogenic liver abscess (PLA) in left lobe of the liver.The patient got cured after correction of calcium metabolism disorders,treatment with antibiotic and receiving percutaneous tube drainage.We concluded that we should remain on high alert of those patients with DM and the history of cancer,when he or she gets fever of unknown origin and abdominal tenderness.PLA should be considered.

BACKGROUND: After internal fixation is applied to femoral shaft fracture with medial cortical defect, the fixation device is often bended and broken due to the stress on it. So far, reliable methods have not been found to solve this problem in clinic.OBJECTIVE: To evaluate the biomechanical stability of the allograft bone plate after a bony defect of the medial cortex is reconstructed with allograft bone plate.DESIGN: A randomized controlled experimental study.SETTING: This trial was conducted in the Department of Orthopaedics, the 175 Hospital of Chinese PLA, and Laboratory of Biomechanics, First Military Medical University of Chinese PLA.PARTICIPANTS: This trial was conducted in Laboratory of Medical Biomechanics, First Military Medical University. MTS858 Biomix biomaterial testing machine was used to simulate model of femoral shaft fracture on 3male adult femurs donated voluntarily by their relatives, aged 23, 24 and 28years old.INTERVENTIONS: The fracture model of medial cortical defect was made in the femurs. Different kinds of fixation were applied and the results were compared between fixated femurs and the normal ones. The fixations included steel plate fixation(fixation for group 1 ), steel plate with allograft bone plate fixation(fixation for group 2), steel plate with allograft bone plate fixation and reduction of the medial cortical fragment(fixation for group 3).MAIN OUTCOME MEASURES: The vertical compression displacement under 500 N load, three-point bending strength under 10 N and anti-torsional angle under 300 N load are all measured.RESULTS: The vertical compression displacement and three-point bending strength of the control group were insignificantly different from those of the fixation group 3 ( P ＞ 0.05), but significantly different from those of the fixation group 1 and 2 ( P ＜ 0.05). The anti-torsional angle of the control group was significantly different from that of the three fixation groups( P ＜ 0. 05) . The result of fixation in fixation group 1 was the worst, better in fixation group 2and the best in fixation group 3.CONCLUSION: When there is a medial cortical defect in the femur, reconstruction with a bone plate can recover the integrity of the femoral medial cortex, and the successful rate of the plate internal fixation is increased.

Objective This study aimed to explore the expression trends of innate immune cells and immune-checkpoint molecules validated by data calculation in the process of oral mucosal carcinogenesis,as well as to explore methods of suppressing oral mucosal carcinogenesis based on immunotherapy by predicting their interactions.Me-thods 1)The cancer genome atlas(TCGA)database comprehensively scores immune cells and immune-checkpoint molecules in the process of oral mucosal carcinogenesis and screens out intrinsic immune cells and immune-check-point molecules that interfere with tumor immune escape.2)Clinical patient blood routine data were collected for the statistical analysis of peripheral blood immune cells during the progression of oral mucosal carcinogenesis.Immune cells in peripheral blood that may affect the progression of oral mucosal carcinogenesis were screened.3)Immunohis-tochemical staining was performed on intrinsic immune cells and immune-checkpoint molecules validated based on da-ta calculation in various stages of oral mucosal carcinogenesis.4)Special staining was used to identify innate immune cells in various stages of oral mucosal carcinogenesis based on data-calculation verification.5)Survival analysis was conducted on intrinsic immune cells and immune-checkpoint molecules validated based on data calculation during the process of oral mucosal carcinogenesis.The association of intrinsic immune cells and immune-checkpoint molecules with the prognosis of oral squamous cell carcinoma was verified.Results The expression of monocytes and neutro-phils increased during the process of oral mucosal carcinogenesis.The expression of eosinophils showed a single peak trend of up and down.The expression of mast cells decreased.In the process of oral mucosal carcinogenesis,the ex-pression of the immune-checkpoint molecules cytotoxic T-lymphocyte-associated protein 4(CTLA4)and programmed cell death-ligand(PD-L1)increased.The expression trends of monocytes,neutrophils,and eosinophils were positively correlated with those of CTLA4 and PD-L1 immune-checkpoint molecules.The expression trend of mast cells was negatively correlated with the expression of CTLA4 and PD-L1.Monocytes,neutrophils,and eosinophils may pro-mote tumor immune escape mediated by CTLA4 and/or PD-L1,thereby accelerating the progression of oral mucosal carcinogenesis.Mast cells may inhibit tumor immune escape mediated by CTLA4 and/or PD-L1,delaying the progres-sion of oral mucosal carcinogenesis.Conclusion Therefore,interference with specific immune cells in innate immu-nity can regulate the expression of CTLA4 and/or PD-L1 to a certain extent,inhibit tumor immune escape,and delay the progression of oral mucosal carcinogenesis.

Objective To study the irradiation dose of organs at risk (OAR) in involved field radiation and extended field radiation in patients with thoracic esophageal cancer who received intensity modulated radiotherapy (IMRT). Methods A total of 40 patients with thoracic esophageal cancer were treated with IMRT. The involved field, extended field, and OAR were outlined to generate IMRT plans. The conformity index (CI) and homogeneity index (HI) of planning target volume (PTV) and the irradiation parameters of OAR were evaluated for the two plans. Paired t-test was used for comparison of irradiation parameters. Results The PTV of both plans received the prescribed dose. There were no significant differences in CI and HI of PTV between the two groups (P = 0.317, 0.130). There were significant differences in average lung dose, lung V₅, lung V₂₀, lung V₃₀, spinal cord D_mean, heart D_mean, heart D_max, heart V₃₀, heart V₄₀, and heart V₆₀ between the two groups (P < 0.01). Conclusion Compared with the extended field, the involved field can reduce the irradiation dose of ORA in patients with thoracic esophageal cancer, thus reducing the risk of radiation.