ObjectiveTo analyze the clinical effect of internal fixation with grip-type of Ni-Ti alloy plate in treatment of multiple ribs fractures.MethodsClinical data of 50 patients with multiple ribs fractures treated by internal fixation t with grip-type of Ni-Ti alloy plate were retrospectively analyzed.ResultsThe chest pain alleviated,the shape of bony thorax recovered, paradoxical respiration vanished, and dyspnea relieved significantly in all cases after operation.Two months after operation, chest X-ray indicated healed fractures, internal fixation without loosening and breaking off, no chest deformity in all patients.Followed up 2 to 14 months,an average of 9 months,and no complication was found.ConclusionThe internal fixation with grip-type of Ni-Ti alloy plate in treatment of multiple ribs fractures was simple ,convenient,less invasive ,good tissue compatibility, stable fixation, less complications, and clinical results were satisfactory.

Objective To investigate the risk factors of syncope symptom in patients with pulmonary embolism (PE).Methods 457 patients with confirmed pulmonary embolism were recruited in the study.They were divided into two groups:the syncope group (44 patients) and the group without syncope (413 patients).The clinical manifestation,laboratory examination,physical examination,imagingof all patients were analyzed by unconditional logistic regression.Results (1) Single factor analysis,prevalence of syncope was 9.6％ (44/457) in these patients with PE.Those with syncope had some higher risk factors,including age over 60,coronary heart disease,hypertension,stroke and lower limb vein thrombosis history.The proportion of falling pressure chest painand centricity thrombus in syncope group were increasing compared with the groupwithout syncope.Pulmonary embolism severity index (sPESI) score was higher than groupwithout syncope.(2) Multivariate analysis showed that hypertension coronary heart disease and Centricity thrombus were the independent correlates of the presence of syncope in the patients with PE.Conclusions Patients who had histories of hypertension and coronary heart disease may have the higher risk factors of syncope.Blood pressure falling and central localization may be more likely to happen in PE patients with syncope.

Nine known compounds were isolated from the chlorofrom soluble fraction of ethanolic extract of Belamcanda chinensis(L. )DC.. Their structures were identified as irigenin(Ⅰ),dichotomitin(Ⅱ),irisflorentin (Ⅱ),3-stigmastenol (Ⅳ), apocynin (Ⅴ), tectoridenin (Ⅵ), ?-sitosterol (Ⅶ), 3', 4', 5, 7-tetrahydroxy-8-methoxyisoflavone (Ⅶ)and polyoctapenten (Ⅹ) by spectorscopic methods (UV, IR, EIMS, 1HNMR, 13CNMR). Compounds Ⅱ, Ⅳ, Ⅹ and Ⅻ were obtained for the first time from the plant.

The authors adopted an auto control experimental research on 18 male adult dogs with 36 sides of femoral heads and necks which were divided into two groups. They were separately made models of old fracture of femoral neck and avascular necrosis of famoral head. Two wecks later, The free fibula with microvascular an astomosis was tranplanted. All experimental dogs were examined with X-ray, pathohitology, electron microscopy, 99~mTc-MDP scanning and tetracycling labeling after operation.The experiment showed that the free fibular graft with mierovascular anastomosis could provided a new system of vascula supply to the injured femoral head. The hard free fibula and the metallic internal fixation were inserted in femoral head and neck. After the Operation, in the fracture area the fibula formed a bone-bridge which not only diminished the stress force but also prevented rotation displacement of the bone fracture The periosteum of the transplanted fibula also took part in the repair course of avascular nerosis of femoral head.

118 cases with uper and median partialfibulectomy were reported in this paper. Of them50 cases were followed up 1～8 years. The clinicalfunction, foot arch and X-ray of bilaleral ankleswere examined. Ankle joint function was mea-sured with the instrument made by ourself. Afteranalysis and valuation of the results, our conclu-sion is that uper and median partial fibulectormydoes not affect the ankle joint function. Thereforethe fibula being considered as a donor bone is ac-ceptable.

Objective To investigate the effect of N-nitro-L-arginine (NO2Arg) on the development of morphine tolerance and dependence.Methods Forty male SD rats weighing (180 ? 18)g were randomly divided into 5 groups for the study of morphine physical dependence and tolerance : group Ⅰ normal saline; group Ⅱ morphine; group Ⅲ morphine + 1 mg?kg-1 NO2Arg; group Ⅳ morphine + 5 mg?kg-1 NO2 Arg ; group Ⅴ morphine +20 mg?kg-1 NO2Arg. Twenty-four male Kunming mice weighing (20.0 ? 2.3)g were randomly divided into 3 groups for the study of psychological dependence: group Ⅵ morphine; group Ⅶ dihydro etorphine; group Ⅷ normal saline. The morphine physical dependence was induced by dose increment. The degree of morphine tolerance was assessed by the pain threshold to heat radiation using tail-flick test. The degree of morphine physical dependence was determined by evaluating the abstinence syndrome precipitated by 4 mg?kg -1 naloxone. The psychological dependence of mice was evaluated by conditioned place preference. Results Consecutive injection of NO2Arg inhibited the development of morphine tolerance in a dose-dependent manner. 5 mg?kg-1 NO2 Arg suppressed most abstinent symptoms of morphine dependent rats. The duration when morphine and dihydro etorphine psychologically dependent mice stayed in the preferred compartment increased significantly from (6.1? 2.0)min and (8.0?0.7)min to (9.3?1. l)min and (9.5 ? 1.2) min by 4 mg?kg-1 NO2 Arg. Conclusion NO2 Arg can inhibit the development of morphine tolerance and dependence and reverse the existing psychological dependence.

Objective To compare the therapeutic effect of azithromycin and erythromycin in the treatment of children with Mycoplasma pneumoniae infection complicated with central nervous system involvement.Methods Mycoplasma pneumoniae infection in children with central nervous system damage treated in our hospital from March 2014 to June 2015 were selected as the observation object.According to the treatment method,it was divided into treatment group(45 cases)and control group(50 cases),the control group was given erythromycin tablets,the treatment group given azithromycin.To observe the therapeutic effect of two groups,compared the cerebrospinal fluid inflammatory cytokine levels and lung function of the two groups before and after treatment.Results The effective rate of treatment group was significantly higher than that of control group,and the difference was statistically significant(P<0.05); After treatment,the indexes of lung function in patients of the two groups were increased before treatment,and the treatment group increased more significantly(P<0.05); The level of hs-CRP,IL-6 and other inflammatory cytokine of the two groups of patients before treatment had no significantly difference,after treatment,the two groups of patients with the above indicators were lower than before treatment,and the treatment group decreased more significantly(P<0.05).Conclusion Azithromycin and erythromycin in children with Mycoplasma pneumoniae infection complicated with central nervous system involvement have better treatment effect,and the effect of azithromycin is better,has a high clinical value.

Objective To discuss the preoperative diagnosis and the effect of microsurgical transsphenoidal surgery of pituitary Rathke's cleft cysts.Methods Retrospective analysis was performed from January,2011 to May,2015 on 62 cases of Rathke's cleft cyst which confirmed by surgery and pathology at the First Affiliated Hospital of Sun Yat-sen University.Sixty-two cases were performed by the surgery of transsphenoidal approach.Results There were 50 cases with a correct preoperative diagnosis of and consider Rathke's cleft cyst,12 cases of misdiagnosis.Postoperative follow-up was performed within 6-12 months,and the patient's clinical symptons were improved in different degrees,1 case of recurrence,no deaths and serious complications.Conclusion The diagnosis of Rathke's cleft cyst need for comprehensive considerations from many aspects,and the improvement of diagnosis rate base on the clinical features,endocrine examination,and imaging data.The microsurgical transsphenoidal surgery is safe and effective treatment for Rathke's cleft cyst.

Objective: To observe the efficacy of knee-balancing manipulation plus heat-sensitive moxibustion in treating knee osteoarthritis (KOA) and its impact on the expression of C-telopeptide of type Ⅰ collagen (CTX-Ⅰ), tartrate-resistant acid phosphatase 5b (TRACP-5b), A disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4), and matrix metalloproteinase 3 (MMP-3). Methods: A total of 134 unilateral KOA patients were randomized into a knee-balancing group, a heat-sensitive moxibustion group, and a joint intervention group. The knee-balancing group received knee-balancing Tuina (Chinese therapeutic massage) manipulation for treatment. The heat-sensitive moxibustion group received heat-sensitive moxibustion treatment. The joint intervention group received the heat-sensitive moxibustion in addition to the knee- balancing manipulation. The intervention period lasted for four weeks. After the treatment, and at the 2-week and 6-week follow-ups, the three groups were assessed using the visual analog scale (VAS) for knee joint pain and Western Ontario and McMaster Universities arthritis index (WOMAC), and clinical efficacy was also evaluated. The enzyme- linked immunosorbent assay was adopted to detect the expression levels of serum CTX-Ⅰ, TRACP-5b, ADAMTS-4, and MMP-3. Results: The knee-balancing group had 44 participants, but one dropped out; there was no dropout case among the 44 participants in the heat-sensitive moxibustion group; among the 46 participants in the joint intervention group, two cases dropped out. After the treatment, and at the 2-week and 6-week follow-ups, the total effective rate was found higher in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups (P<0.05). Compared with the baseline, the VAS and WOMAC scores and the serum levels of CTX-Ⅰ, TRACP-5b, ADAMTS-4, and MMP-3 decreased significantly in all three groups after treatment and at the 2-week and 6-week follow-ups (P<0.05). At the same three time points, the VAS and WOMAC scores and serum levels of CTX-Ⅰ, TRACP-5b, ADAMTS-4, and MMP-3 were lower in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups (P<0.001). Conclusion: Either used alone or combined, the knee-balancing manipulation and heat-sensitive moxibustion therapy can improve the symptoms and down-regulate the serum levels of CTX-Ⅰ, TRACP-5b, ADAMTS-4, and MMP-3 in KOA patients, producing durable efficacy; nevertheless, a more significant efficacy can be achieved by combining the two methods.

Objective 99Tcm-ciprofloxacin(Infecton)and 99Tcm-HIgG are both radiopharmaceuticals for inflammation and infectious disease imaging.It was reported that99Tcm-ciprofloxacin (Infecton)Was able to distinguish inflammation from infection.while 99Tcm-HIgG was a nonspecific agent.The study Was designed to compare the in vivo characteristics between 99Tcm-ciprofloxacin(Infecton)and 99Tcm-HIgG in rabbit model of inflammation.Methods Eight rabbits were grouped as inflammation model(the first group).infection model(the second group),concomitant inflammation and infection model(the third group),and control(the fourth group)groups.A total of 185 MBq(0.5 m1)99Tcm-ciprofloxacin(Infecton)Was administered intravenously to each rabbit.a serious dynamic images were acquired till 24 h post-injection.Repeated examination with99Tcm-HIgG was carried out 2 d later.Resuits 99Tcm-ciprofloxacin(Infecton)scan was negative in the inflammation models and controls.and was positive in the infection models.In the third group99Tcmciprofloxacin(Infecton)showed infection focus in the left thigh but negative uptake at inflammation focus in the right thigh.99Tcm-HIgG scan were positive in all models.The optimal image time for99Tcm-ciprofloxacin(Infecton)was 3 h after administration.but positive image could still be observed 24 h later.Conclusion 99Tcm-ciprofloxacin(Infecton)appears to specifically accumulate in the infective lesion.