BACKGROUND: A mass of unknown remains are founded in sodium hyaluronate product when it was tested for quality control. OBJECTIVE: To qualify and quantify unknown residual solvents of sodium hyaluronate product and determine hazardsaccording to standard toxicological data. DESIGN, TIME AND SETTING: A quality and quantity study with combined gas chromatography mass spectrometry was performed at National Institute for the Control of Pharmaceutical and Biological Products from May to June 2007.MATERIALS: Experimental samples were spot-checked, and purified water was also used.METHODS: The samples were qualified and quantified using combined gas chromatography mass spectrometry.MAIN OUTCOME MEASURES: Methanol, xylene and ethyl benzene were qualified and quantified.RESULTS: Combined gas chromatography mass spectrometry demonstrated that residual solvents in the sodium hyaluronateproducts were methanol, xylene, and ethyl benzene. The quantization of methanol was 414.365 μg/mL, the quantization of o-xylene was 0.19 μg/mL, and the quantization of ethyl benzene was 0.22 μg/mL. CONCLUSION: Methanol, xylene, and ethyl benzene were firstly identified as residual solvents in sodium hyaluronate products. Besides, we discussed methods of qualifying and quantifying these three residual solvents.

Objective To explore the real experiences of young nurses who accepted training of concept maps,to evaluate its effectiveness and feasibility,and provide guidance for clinical training and usage.Methods 50 young nurses who worked in a 3A hospital in Ningxia for 1～3 years were trained using concept maps teaching method for a period of 12 weeks.Using phenomenological method of qualitative research,12 nurses among them were invited to face to face,semi-structured in-depth interviews after one month of attending the training of concept maps.The data were analyzed after using Colaizzi method collected.Results Respondents felt advantages of applying concept maps on learning,thinking,and clinical usage.However,there were certain problems and difficulties of applications.Conclusions Training young nurses using concept maps shows many advantages,which will help improve the quality of clinical care training.But there were some problems in its application which need to be solved.

Objective To analyse the effects of serum estradiol levels during controlled ovarian hyperstimulation (COH) on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods The clinical data of 472 patients undergoing IVF-ET with GnRH analogues recombinant FSH long protocol were retrospectively analysed. The area under the curve (AUC) of estradiol (E2) level was calculated during COH, and patients were categorized into groups according to the percentile of AUC of E2(AUCE2) during COH. The general characteristics and parameters related to the outcomes of IVF-ET were compared among groups. Results The 10th percentile and 90th percentile of AUCE2 were 3 347.0 pmoL/L and 14 414.3 pmol/L, respectively. Four hundred and seventy-two patients were divided into lower reaction group (AUCE2 3 347.0 pmol/L, n=48), normal reaction group (14 414.3 pmol/L>AUCE2 > 3 347.0 pmol/L, n=376) and higher reaction group (AUCE2≥14 413.3 pmol/L, n=48). There was no significant difference in age, body mass index, baseline follicle stimulating hormone level, time of treatment with gonadotropin, endometrium thickness on day of transfer and embryos transferred(P>0.05). Compared with lower reaction group and normal reaction group, the number of oocytes per retrieval and number of embryos frozen were significantly larger(P<0.01) and the mild/severe ovarian hyperstimulation syndrome rate was significantly higher in higher reaction group(P<0.05). There was no significant difference in fertilization rate, cumulative embryo score, high-grade embryo rate, clinical pregnancy rate and implantation rate among groups (P> 0.05). Conclusion Sustained snpraphysiological serum E2 levels during the COH process do not adversely affect the quality of oocytes and embryos, clinical pregnancy rate and implantation rate to some extent in IVF-ET.

Objective To explore the clinical effect of periarticular knee fractures combined with anterolateral ligament (ALL) avulsion fracture.Methods From June 2014 to November 2015,13 patients with ALL avulsion fracture in periarticular knee fractures were fixed by the star plate,cannulated or screws suture anchor,including 9 male and 3 female with the mean age of 39.5 years (range from 28 to 51 years).6 patients were diagnosed distal femoral fracture,4 tibial plateau fracture,and 3 tibial intercondylar eminence avulsion fracture which all combined with ALL avulsion fracture.Postoperatively,all patients were treated with the adjustable knee brace for 3 months.Results All patients were followed up for 4-20 months,the mean follow-up time was 13.5 months.The average surgical time was 130 min (range from 90 to 210 min).In all 13 patients,ALL was found and identified.Bone union was obtained in all patients,and the bone union time was 11.4 weeks (10-12 weeks).7 cases were fixed with star plate,5 cases were fixed with hollow screw,and 1 case was fixed with anchor.All follow-up patients underwent anteroposterior and lateral X-rays.Pain,swelling and functional recovery of the knee joint were observed.Patients were assessed postoperatively with International Knee Documentation Committee (IKDC) score,Lysholm score,and Tegner activity scale to evaluate the clinical effect.At the last follow-up,all patients had full range of motion of the knee joint which from 0° to approximate 120°.The Lysholm,objective IKDC were 86.5 and 84.6 respectively.Among the 13 patients evaluated,9 patients were graded A,and 4 patients were graded B by subjective IKDC.The Tegner activity scale at the last follow-up was 6.7.Incision of poor healing in 1 case,and got healed after 32 d cleaning dressing.Conclusion This study confirmed the presence of the ALL.The fixation of ALL avulsion fracture in periarticular knee fractures can be an effective procedure at a minimum follow-up of 13.5 months.

Objective: To explore the impact of using sports activity tracking APP data recording and social fitness activities on physical and mental health of college students, and to provide theoretical support for using APP to participate in fitness. Methods: A total of 96 students from Xi an International Studies University and Northwest University were recruited and divided into the control group(35 students), the recording group (29 students)and the interactive group(32 students) by using random number table. The recording group and the interactive group used APP for 12 weeks of exercise intervention, while the control group receive no intervention. For any intervention, participants received physical fitness tests before and after the intervention. Results: After the intervention, sit and reach [(19.36±4.55)cm], lung vital capacity [(2 929.93±422.52)mL], sit ups for 1 minute(39.71±8.32) times, standing long jump [(165.14±14.73)cm] in girls of the recording group significantly increased compared with pre intervention [(16.39±6.15)cm, (2 690.93±380.45)mL, (36.14±9.53) times, (157.64±14.93)cm]( t =-3.34,-2.82,-3.52,-4.55, P < 0.05 ), and the BMI of boys[(22.79±2.18)(22.19±2.22)km/m 2] significantly decreased, and pull up of boys[3.50(2.00,4.75), 4.50 (3.25,9.25)times] significantly increased( t=3.90,Z=-2.04,P <0.05). After the intervention, sit and reach and pull up of boys in the interacticve group [(13.08±2.23)cm,6.00(0.00,12.00)times], and sit and reach [(21.43±5.14)cm], lung vital capacity [(3 259.33±562.70)mL], standing long jump [(171.83±19.17)cm] among girls in the interactive group was significantly higher than that before the intervention [(9.78±3.96)cm, 1.00(0.00,7.50)tims, (18.86±6.26)cm, (2 870.94±429.62)mL, ( 162.78 ±17.20)cm] ( t/Z =-4.22,-2.02,-3.43,-2.68,-3.84, P <0.05). After the intervention, compared with the control group, lung vital capacity and standing long jump scores of boys in the recording group were significantly improved, while the scores of sit ups for 1 minute in girls were significantly improved; sit and reach and standing long jump performance of boys in the interactive group were significantly improved; sit and reach and lung vital capacity among girls in the interactive group were significantly improved( P <0.05). Boys in the interactive group showed a significant improvement in sit and reach compared to the recording group ( P <0.05). Conclusion Using sports activity tracking APP can effectively improve students physical fitness, can promote student participation and persistence in physical activity.

OBJECTIVETo evaluate cost-effectiveness of poking reduction and open reduction for the treatment of Sanders type II calcaneal fractures, in order to provide evidence for standard treatment.

METHODSFrom 2006.10 to 2008.10, 80 patients with Sanders type II calcaneal fractures were selected from Shandong Provincial Hospital of Traditional Chinese Medicine and randomly divided into poking reduction group and open reduction group with 40 cases in each group. There were 26 males and 14 females in poking reduction group and 30 males and 10 females in open reduction group. The average age of patients in poking reduction group was (36.60+/-3.15) years, and (37.10+/-3.45) years in open reduction group. Bohler angle, Gissane angle, the width of central calcaneus, stance phase of gait, HM-HL,arch index and subtalair joint flexibility were measured. The clinical results and expenses of the two treatment schemes were compared and concluded with the method of cost-effetiveness analysis.

RESULTSIn the poking reduction group and open reduction group, the Böhler angle were (30.32+/-1.72) degree and (30.54+/-3.13) degree, Gissane angle were (133.73+/-6.73) degree and (134.86+/-4.90) degree, the width of central calcaneus were (30.18+/-1.59) mm and (30.24+/-1.25) mm, stance phase of gait were (0.679+/-0.070) s and (0.715+/-0.090) s, HM-HL were--(36.49+/-7.56) N and -(34.32+/-6.50) N,arch index were (30.26+/-2.69) and (30.47+/-1.89), and subtalair joint flexibility were (10.53+/-2.30) degree and (10.89+/-1.86) degree respectively. The cost-effectiveness ratio (C/E) were 6.06 and 136.19 respectively.

CONCLUSIONCost-effectiveness ratio of the poking reduction is superior to that of the open reduction in treating Sanders type II calcaneal fractures. Poking reduction is a useful method to treat Sanders type II calcaneal fractures with rapid wound healing and less cost.

Adult ; Calcaneus ; injuries ; surgery ; Cost-Benefit Analysis ; Female ; Fracture Fixation, Internal ; economics ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

Objective To investigate the expression of pSTAT5 in 7 pancreatic carcinoma cell lines,and the change of expression of pSTAT5 in pancreatic carcinoma cells SW1990 after growth hormone (GH) treatment, and explore its molecular mechanism. Methods Human pancreatic carcinoma cell lines (SW1990, Cap-1, Colo, Mia, AsPc, P3, PANC1) were cultured in vitro, and Western blotting was used to detect the expression of pSTAT5 in these cell lines. SW1990 in exponential growth phase was collected and nude Balb/c mice were inoculated with SW1990 cells. When tumors became palpable after inoculation, mice (normal saline group). 1 h, 2 h and 24 h after the last dose of GH treatment, the mice were sacrificed.Western blotting was used to detect the expression of pSTAT5 in SW1990 and inoculation tumor cells after GH injection. Results Positive expression of pSTAT5 was observed in all human pancreatic carcinoma cell lines (SW1990, Cap-1, Colo, Mia, Aspc, P3, PANC1). 5 minutes after GH (50 ng/ml) stimulation, the expression of pSTAT5 in SW1990 was 0.57 ±0.05, which was significantly increased; and it reached 0.64 ±0.04 at 10 minutes, then decreased to 0.39 ±0.03 at 15 minutes, however, it remained higher than that in the control group at 1 h (0.33 ± 0.02 vs 0.25 ± 0.06), and its expression at 2 h was 0.26 ± 0.03 and returned to the normal level. The expression of pSTAT5 in xenograft was not significantly changed. Conclusions GH could rapidly up-regulate the expression of pSTAT5 in SW1990 but the effect lasted for a relatively short period. GH had no significant effect on the expression of pSTAT5 in xenograft.

Objective To compare the cost-effectiveness between endoscopic submucosal dissection (ESD) procedure and traditional surgery for the treatment of early gastrointestinal cancer or precancerous lesions.Methods A total of 866 early GI cancer/precancerous patients who had been admitted to Chinese PLA General hospital and Qilu hospital were included in this study.The medical records of all 866 patients were reviewed.Patients were divided into ESD group and traditional surgery group.Parameters of each patient,such as time of hospitalization,total treatment cost and incidence of complications,were documented and later compared in detail.Results A total of 607 patients were included in the ESD group and 259 in the traditional surgery group.There was no statistical difference in complete resection rate between the two groups (93.1％ vs 93.0％,P ＞ 0.05).The ESD group showed a shorter mean hospitalization time (d)(13.01 vs 18.88,P ＜ 0.05) and lower treatment cost (RMB) than the traditional surgery group (22932.17 vs 57993.88,P ＜ 0.05).The incidence of hemorrhage and perforation for each group were 3.63％ and 3.10％ respectively,which were not significantly different (1.98％ vs 3.01％,P ＞ 0.05; 2.80％ vs 1.16％,P ＞ 0.05).Conclusion ESD and surgery are both effective for early gastrointestinal cancer/precancerous lesions therapy,but ESD procedure is superior to surgery in terms of hospitalization time and expediture.

Objective: To investigate the clinical features of patients with hyperextension bicondylar tibial plateau fractures (HEBTPs), and assess surgical effectiveness of HEBTP and non-HEBTP fracture patients. Methods: From June 2014 to May 2017, 82 patients with bicondylar tibial plateau fracture were included in this study. There were 63 patients with 63 knees (76.8%) that had sustained non-HEBTPs, and 19 patients with 19 knees (23.2%) that had HEBTPs, including 49 males and 33 females with a mean age of 48.3 years (range, 22-76). Of the 19 HEBTPs patients, 4 cases were hyperextension valgus injury, 9 cases were hyperextension varus injury, and 6 cases were pure hyperextension injury. All patients were treated with open reduction internal fixation combined with bone grafting or non-bone grafting. All follow-up patients were evaluated clinically and radiographically, included the incidence of associated injuries, infection, posttraumatic osteoarthritis, range of motion (ROM) of knee, numeric rating scale (NRS) for assessment of pain, and Short Musculoskeletal Functional Assessment (SMFA) scores for assessment of knee function. The fracture healing and postoperative alignment were assessed with anteroposterior and lateral X-rays. Results: All patients were followed up for 12-22 months, the mean follow-up time was 15.4 months. Bone union was obtained in all patients, and the bone union time was 12.6 weeks (ranged: 12-16 weeks). At the last follow up, all patients had full range of motion. The incidence of significant associated injuries was 36.8% in the HEVBTP group compared with 15.8% in the non-HEBTP group. The incidence of popliteal artery injury, common peroneal nerve injury and ligament injury that needed repair in 19 HEBTPs patients was 21.1%, 26.3% and 31.6%, respectively, while the corresponding incidence of complications in 63 non-HEBTPs patients was 3.2%, 4.8%, and 9.5%, respectively. The NRS pain score of HEBTPs and non-HEBTPs at 12 months after surgery was 3.89±1.9 and 2.76±1.88, respectively. The value of HEBTPs patients was higher than that of non-HEBTPs patients, But the difference was not statistically significant. The SMFA scores of HEBTPs and non-HEBTPs patients at 12 months after surgery were 27.27±19.44 and 17.09±15.87, respectively. Patients with HEBTP had higher functional (SMFA) scores and a trend of higher pain scores than those with non-HEBTP, indicating associated soft-tissue damage and developed posttraumatic osteoarthritis. Conclusion The present showed that the HEBTP is a unique fracture. These injuries result in worse functional outcomes than non-HEBTP. Physicians must recognize the possible associated injuries (included ligaments, vessels and nerves), and the treatment effect of HEBTP is relatively poor.

OBJECTIVETo establish a rat model of low calcium diet related hyperoxaluria and explore its features.

METHODSBy means of randomized blocks design, totally 24 SD male rats were divided into low calcium diet group, medium calcium diet group, and high calcium diet group. Each group was sequentially fed on different calcium diets for 3 days. The urinary volume within 24 hours was recorded, the consistency of urinary oxalate by high-efficiency liquid chromatography, and the consistency of urine creatinine by automatic biochemical analyzer. The consistency was corrected to the output of urinary oxalate of rats in 24 hours, and the results were evaluated by repeated measurement of variance analysis and multivariate analysis of variance.

RESULTSThe output of urinary oxalate of rats in 24 hours varied with time (F=7.893, P0.05). The output of urinary oxalate of rats in 24 hours varied with group division (F=3.565, P<0.05). The output of urinary oxalate in 24 hours in three groups on the third day was significantly higher than that on the first day (P<0.05).

CONCLUSIONBy controlling the calcium intake, we successfully established the model of low calcium diet related hyperoxaluria in rat.

Animals ; Calcium Carbonate ; administration & dosage ; Diet ; Disease Models, Animal ; Hyperoxaluria ; etiology ; urine ; Male ; Rats ; Rats, Sprague-Dawley