Objective To explore the effect and safety of compression and distraction technique by external fixation without grafting in treatment of noninfectious nonunion of tubular fractures.Methods 43 patients were randomly divided into 2 groups by visiting sequence with random number,odd into the observation group,even into the control group.The observation group(22 cases) adopted the external fixation retractor pressure treatment,the control group(21 cases) was given extemal fixation combined with locking plate treatment.The efficacy of two groups was compared.Results 43 patients were followed up for 6 ～ 15 months,average 7.5 months.The bone healing time was 3 ～ 14 months,average 5.1 months.43 patients were all healed.The total effective rate of the observation group was 81.8％,which was significandy higher than 66.7％ in the control group (Z =9.654,P =0.001).There were no significant differences in adverse reactions and complications between the two groups (x2 =0.068,P =0.795).Conclusion The compression and distraction technique by external fixation in the treatment of noninfectious nonunion of tubular fractures has obvious curative effect,it can be widely used in clinical practice.

Type 1 diabetes is the main type of diabetes mellitus among children and adolescents and the incidence has steadily increased worldwide in the past 20 years,so more and more people pay attention to the pediatric type 1 diabetes.This article reviews the worldwide research progresses of epidemiology,treatment and management of type 1 diabetes.By comparing the research progresses home and abroad,we can know the gaps home and abroad better,so as to indicate potential paths for future research in China.

Objective To explore the clinical effects of hysteroscopy treatment for uterine septum guided by B Ultrasound.Methods Clinical data of 107 patients with uterine septum were retrospectively analyzed after performing transcervical hysteroscopy resection of septum with being monitored by B Ultrasound,Results All of the operat.ions were successful,and there was no uterine perforation,intestinal injury or water intoxication.Following up after operation,endometrial and uterine morphology were normal and all patients had pregnancy and delivery.Conclusion Hysteroscopy guided by B Ultrasound could make operation easier,time shorter,bleeding less,trauma smaller,safer,pregnancy rate higher,complications of pregnancy less,and it could easier be accepted.

Objective To investigate effects of cemented hip arthroplasty applied to treat intertrochanteric fracture of aging patients.Methods 21 cases of clinical data of patients with intertrochanteric fracture treated with cemented hip arthroplasty were retrospectively analyzed,and hip functions were evaluated according to Harris grading.Results The mean time of surgery was (42.2 ± 8.6) main,mean blood loss was (597 ± 83) ml,mean time of hospital stay(specialist hospital stay not included) was (16.5 ± 1.7) days,all cuts were primary healing,and mean time of healing was (15.7 ± 0.2)days.After operation 5 parents had respiratory tract infection and improved by symptomatic anti-inspection therapy.3 cases had deep vein thrombosis and improved by inferior vena cava filter input and thrombolysis therapy.1 case had dislocation after cemented hip hemiarthroplasty and improved by legs brace booth outside fixed for 3month.21 cases had following up for 6 months after operation.All fractures were cured,without any osteolysis,loosening of the prosthesis or heterotopic ossification.65 ～ 89 scores by Harris hip function grading,and the mean score was 74.1.13 cases were good,7 cases less than ideal and 1 case poor.Conclusion Cemented hip arthroplasty is an effective method to treat intertrochanteric fracture of aged patients.After operation,the patients can do early activity and have long-term good function recovery.

Objective To observe the clinical effect of plasmin combined with aspirin in treating acute cerebral infarction and to explore the influence to blood rheology and nerve function.Methods 148 cases with acute cerebral infarction were randomly divided into two groups.The control group (n =74) was treated by honghua injection.The study group (n =74) was treated by plasmin combined with aspirin.After treatment,the clinical effect,blood rheology and neurological recovery were observed.Results The total effective rate of the study group was 97.2％,which was significantly higher than that of the control group(74.3％) (x2 =15.88,P ＜ 0.05).The blood rheology indexes of the two groups had improved and neural function of the two groups was restored,but those in the study group were obviously better than control group (t =3.56,3.42,4.26,3.22,4.16,all P ＜ 0.05).Conclusion Plasmin combined with aspirin in treating acute cerebral infarction has accurate clinical curative effect,can markedly improve the blood rheology and promote nerve functional recovery,is worth of clinical spreading.

Sepsis-associated encephalopathy is a diffuse brain dysfunction that occurs secondary to infection.It is characterized by alteration of consciousness and cognition,seizure or focal neurological signs.Sepsis-associated encephalopathy is accompanied by abnormalities of electroencephalogram and somatosensoryevoked potentials,increased biomarkers of brain injury and,frequently,by neuroradiological abnormalities.Its diagnosis relies essentially on neurologic examination.Hepatic/uremic encephalopathy,metabolic disturbances,drug overdose,withdrawal syndrome and Wernicke's encephalopathy are the main differential diagnosis of sepsis-associated encephalopathy.Currently,treatment consists mainly of controlling sepsis.Various drugs acting on septic pathophysiology have been tested in septic animals.

The liver is a crucial organ involved in immune and metabolic processes.In multiple organ dysfunction syndrome secondary to sepsis, liver is one of the target organs.Sepsis-associated liver injury worsens the prognosis and mortality.MicroRNAs are single-stranded,non-coding RNAs.MicroRNAs modulate gene expression post-transcriptionally by binding themselves to complementary sites of target genes and degradation proteins.MicroRNAs affect sepsis pathogenesis at multiple levels through regulating signaling pathways and inflammation factors in immune reaction, as well as functions of immune cells.Among microRNAs involved in sepsis pathogenesis,microRNA-155 is critical in sepsis associated liver injury and it is sketchily described in this review.

Objective To evaluate clinical efficacy of Yishen-Bushui-Tongluo decoction in the treatment of multiple sclerosis (multiplesclerosis, MS).Methods 60 patients met the inclusion criteria of MS were recruited into a compound group and a control group, with 30 patients in each. The control group was treated with conventional western medicine, while the compound group was treated withYishen-Bushui-Tongluo decoction on the basis of the control group. Both groups were treated for continuous 3 months, the clinical efficacy, symptoms, signs, expanded disability scale (expanded disability status scale, EDSS) scores, as well as adverse reactions and hormone-year recurrence rate were compared between the two groups.Results After the treatment, the total effective rate was 93.3% (28/30) in the compound group and 73.3% in the control group (22/30), showing statistically difference (χ2=4.320,P=0.038). After treatment, the clinical symptom score (5.1 ± 2.7vs. 7.0 ± 3.1,t=2.532), neurological signs score (5.1 ± 1.6vs. 6.3 ± 1.7, t=2.815), EDSS score (3.4 ± 1.5 vs.4.8 ± 1.5,t=3.615) in the compound group were significantly lower than the control group (P<0.01 or P<0.05); the follow-up period of 1 year showed the recurrence times in the compound group was lesser than the control group (0.31 ± 0.17vs.0.89 ± 0.36;t=7.980,P=0.000).ConclusionsYishen-Bushui-Tongluo decoction combining conventional western therapy can significantly improve the clinical symptoms of MS patients, relieve nervous system damage mitigation, reduce relapse frequency, and reduce the adverse effects of hormones.

Prenatal diagnosis is vitally important to control birth defects.The mature application of detecting biochemical markers in maternal serum and cytogenetic karyotype analysis of amniotic fluid cells , villi cells and umbilical cord blood cells , as well as the development of fluorescence in situ hybridization , nucleic acid amplification , gene sequencing , chips and other molecular biological techniques , have significantly improved the standards of prenatal diagnosis.The application of high-throughput sequencing , a non-invasive detection technique , ushers the development of prenatal diagnostic techniques into a new stage.In the face of a growing number of and constantly updated test items , it is necessary to assess the advantages and limitations of various prenatal diagnostic techniques , so as to realize scientific selection and combination, and utilize the techniques to their fullest potential.

Objective To investigate the effect and necessity of hysteroscopy combined with laparoscopy in the diagnosis and treatment of refractory polycystic ovarian syndrome complicated with infertility.Methods 80 cases of patients with polycystic ovary syndrome (PCOS)combined with infertility were randomly divided into two groups with 40 cases in each group.The testing group used hysteroscopy combined with laparoscopy in diagnosis and treatment while the laparoscopy was only used in the control group.The changes of ovary,ovarian follicles and serum hormone level of the two groups which before and after operation were compared,and the data of postoperative normal ovulation rate,pregnancy rate and abortion rate of the two groups were recorded.Results The follicle number and ovarian volume of the testing group were significantly decreased than that before treatment,and were significantly lower than that of the control group,with statistical difference (t =3.82,3.80,3.74,3.75,all P <0.05).The serum T,LH and LH/FSH of the testing group were significantly decreased than the data before surgery,and were significantly lower compared to the control group with statistical difference (t =9.32,4.06,3.80,all P <0.05).The normal ovulation rate,pregnancy rate and abortion rate of the testing group were significantly higher compared to the control group (90.0%,62.5% and 7.5% vs.72.5%,50% and 15%)χ2 =4.02,4.10,3.90,all P <0.05).Conclusion Hyste-roscopy combined with laparoscopy has an obvious curative effect in the diagnosis and treatment of polycystic ovary syndrome combined with infertility,which can effectively improve ovulation rate and pregnancy rate and reduce the abortion rate,is worthy of clinical application.