Objective　To investigate the factors which affect the bone union of distracted region after limb lengthening, so as improve the curative effect and diminish the incidence of complication. Methods　To look up the latest literatures dealing with the bone union in limb lengthening, then review the procedure of osteogenesis and the affecting factors. Results　The osteogenesis of distracted region after limb lengthening is a sophisticated procedure. It can be affected by the velocity of lengthening, the period of lengthening, the site and method of osteotomy, the age etiology of patient. Conclusion　The bone union of distracted region after limb lengthening can be facilitated by following factors :① the velocity of lengthening slower than 1.0 mm/day; ② moderate delay in distraction; ③ axial shortening of distracted region; ④ micromovement stimulation.

Objective To explore the effects of individualized nutrition intervention on body weight gaining and pregnant outcome in normal pregnant women. Methods Two hundred and twelve normal pregnant women admitted in our hospital before the 12th gestational week were divided into the observation group and the control group. Eighty-eight pregnant women admitted between October 2013 and January 2014 were assigned into the observation group and another 124 pregnant women admitted between June 2013 and September 2013 into the control group. The observation group was given nutrition assessment and nutritional guidance one by one and face to face by the nutritionist at three time points:around the 12 thgestational week, between the 22nd to 24th gestational week, and between the 32nd to 34th gestational week. The control group was given regular antenatal visits and lectures during pregnancy. These two groups were followed up until delivery. The comparisons were down between the groups in terms of body weight gain and complications during pregnancy, delivery mode and the change of perinatal fetus outcome. Results In the observation group, the body weight gaining of the pregnant women during pregnancy, the incidence of gestational diabetes mellitus (GDM) and the cesarean section rate were significantly lower than those of the control group (all P<0.05). The neonatal birth weight and the incidence of macrosomia were significantly lower than those of the control group (all P<0.05). Conclusion Individualized nutritional intervention given by the nutritionist can control body weight gaining during pregnancy, decrease the incidence of GDM, improve the pregnancy outcome and ensure the maternal and child health.

Objective There is still controversy over the effect of hyperglycemia on the tolerance of heart to ischemia/reperfusion(I/R)injury in patients with diabetes mellitus. The aim of this study was to evaluate the effect of hyperglycemia on I/R-induced ventricular arrythmia in isolated diabetic rat hearts. Methods Twenty-four healthy male SD rats weighing 210-250g were randomly divided into two groups: control group(C, n=10) and diabetes mellitus group(DM, n=14). Diabetes mellitus was induced by intraperitoneal injection of streptozotocin 60 mg?kg~(-1). Blood glucose was measured 72h later and every week thereafter. Diabetes mellitus was defined as persistent hyperglycemia(blood glucose≥16.7 mmol/L after meal). The diabeticrats received no insulin. The rats were anesthetized with pentobarbital 60mg?kg~(-1). The hearts were immediately removed and perfused with oxygenated(95% O_2, 5% CO_2)Krebs-Henseleit buffer(KHB)in a Langendorff apparatus at a constant perfusion pressure of 80 mm Hg. The 14 diabetic rats were further divided randomly into 2 subgroups: (1)DM+KHB (n=7) and (2) DM+GLU(n=7) in which glucose 3.6 g was added to KHB 1000ml. After 20 min equilibration all hearts were subjected to 30 min global ischemia followed by 40 min reperfusion. Epicardial electrocardiogram was monitored. The incidence of ventricular tachycardia(VT) and ventricular fibrillation(VF) and their duration were measured. The severity of arrhythmia was quantified by arrythmia score(AS). Coronary outflow was collected for determination of creatine kinase(CK) release. Results The incidence of ischemia-induced arrythmia was significantly lowered in diabetic hearts. The incidence of VT was 14.3% and VF 28.6% in DM+KHB subgroup as compared to 60%(VT) and 100%(VF) in the control group. The CK release was significantly lower in diabetes group(DM) than in control group(C); furthermore the CK release in DM=KHB subgroup was lower than that in DM=GLU subgroup. Conclusion Diabetic rat hearts are less susceptible to I/R induced arrythmia. Hyperglycemic perfusion reduces to some extent the increased tolerance to I/R injury in diabetic rat hearts as shown by increased CK release in DM+GLU subgroup but hyperglycemic perfusion has anti-arrhythmic action as shown by 0% incidence of VT and VF in DM+GLU subgroup.

Objective To investigate the efficacy and safety of statins in primary and secondary stroke prevention.Methods We search in PubMed(1966—2006),Cochrane library(issue 1,2006),CNKI(1979—2006)and VIP(1989—2006)to get systematic reviews(SRs),meta-analyses and randomized controlled trials(RCTs)about statins for stroke prevention.Results We found 4 meta-analyses,8 RCTs about the primary stroke prevention and 1 Cochrane systematic review and an ongoing RCT about secondary stroke prevention.Conclusion Statins therapy can reduce the incidence of stroke,especially in high-risk patients with coronary heart disease,hypertension and diabetes.Statins have positive effect for primary stroke prevention and do not increase the incidence of hemorrhagic stroke and tumor.The clinical evidence about the effect of statins in secondary stroke prevention is insufficient.An ongoing stroke trial will provide important evidence for secondary stroke prevention.

In this study, by analysis of genome structures of E. coli, the relationships between the genomic types of E. coli and the associated diseases were investigated. Samples of sputum, urine and other excretions from patients with different infective diseases were collected. And 62 E. coli strains were isolated from these samples. Intact bacterial genomic DNA was cleaved with I-CeuI, separated by pulsed field gel electrophoresis and then typed on the basis of cleavage map. The results showed that 7 I-CeuI sites were found in all the genome structures of the 62 E. coli, indicating that there were 7 rrn operons in the genomes. The size of genome ranged from 4500 kb to 5000 kb. According to the genome structures, 62 E. coli strains were divided into 30 genome types. It was concluded that genome structures of E. coli isolated from the patients with different infective diseases varied to some extent, suggesting that some genome types of E. coli were closely related to some infective diseases.

OBJECTIVE:To determine the concentration of cefdinir in rat plasma,and investigate its pharmacokinetics. METH-ODS:High performance capillary electrophoresis (HPCE) was adopted by using fused-silica capillary (75 μm,total length of 30 cm,effective length of 21.5 cm),buffer solution of 20 mmol/L citric acid,injection voltage of 10 kV for 10 s,separation voltage of -20 kV,and detection wavelength of 214 nm. 6 rats were intragastrically received cefdinir solution(20 mg/kg). 0.2 mL blood sample was taken from the tail vein before and 0.25,0.5,1,1.5,2,3,4,6,12,24 h after administration. BAPP 2.0 software was used to calculate the pharmacokinetics parameters. RESULTS:The linear range of cedinir ranged 0.2-50 μg/mL(r=0.9997), lower limit of quantification was 0.2 μg/mL. The intra-day(n=6)and inter-day RSDs of(n=3)precision test were no more than 12.2%;RSD of stability test was no more than 9.10%(n=6);method recovery rate was 95.4%-114.3%(RSD=9.0%,n=6);matrix effect was 63.5%-70.2%(RSD=10.39%,n=6). The t1/2 of cefdinir in rats in vivo was(0.54±0.01)h,MRT was(1.90± 0.14)h,cmax was(32.92±0.81)μg/mL,tmax was(1.50±0.02)h,AUC0-24 h was(46.65±0.44)μg·h/mL and AUC0-∞was(46.83± 0.44)μg·h/mL. CONCLUSIONS:The method is rapid,accurate and simple,and can be used for the determination of cefdinir con-centration in rat plasma and its pharmacokinetics research.

OBJECTIVE To investigate the mechanisms for carbapenem resistance in clinical isolates of Pseudomonas aeruginosa from surgical intensive care unit(SICU).METHODS The minimal inhibitory concentrations(MICs) of various antibiotics were detected with agar dilution method;their ?-lactamases were extracted,types of their enzymes were identified and then their physical and chemical characteristics were studied by three dimentional extract test and isoelectric focusing(IEF) electropheresis;primers specific to IMP and VIM genes were utilized to amplify the metallo-?-lactamase genes.The levels of outer membrane protein OprD2 were measured by Western blot.RESULTS Forty one strains were resistant to imipenem from 49 strains of P.aeruginosa isolated from SICU during 3 years.Among them,34 isolates were found to produce high level of AmpC enzymes.Eight produced extended-spectrum ?-lactamases(ESBLs) at the same time.2 produced ESBLs only.No metallo-?-lactamases were detected.The activity of enzymes in the imipenem resistant group(74.32?53.42) was statistically different from the sensitive one(8.7?16.16,P

Objective To explore the effects of two lubricants on skin preparation from donor site in patients with skin flap transplantation. Methods According to digit number table, 83 patients undergoing wound repair using modified fascia flap were divided into observation group (n=41) and control group (n=42). The former group were treated with Johnson K-Y Lubricant, while the latter with talcum powder. The two groups were compared in terms of the skin flap quality from donor site, pain degree and number of bacteria before and after transplantation. Results There was no significant difference in bacteria number before and after transplantation in the two groups (P>0.05), but the difference between the groups was significant (P<0.01). The flap preparation quality in the observation group was significantly better than that of control group and the pain degree was significantly lower than that of observation group. Conclusion Johnson K-Y Lubricant can significantly improve flap preparation quality and reduce pain.

Objective To study the correlation between hyperhomocystinemia and the property of cerebral artery plaque,and the pathogenic mechanism of hyperhomocystinemia resulting in acute cerebral stroke.Methods 60 patients with acute ischemic stroke were chosen.30 patients with normal homocysteine were classified as control group.The other 30 patients with hyperhomocystinemia were classified as observation group.High resolution magnetic resonance imaging(HRMRI) and multi contrast plaque imaging technique were used to measure the cerebral artery plaque burden,the fat ratio of plaques,the hemorrhage within the plaque and fibrouscap rupture.The number of inflammatory cells in the plaque and the density of the new blood vessels were identified using the transfer constant of the contrast medium.Results In the observation group,4 cases with low-risk plaques (13.33％),10 cases with middle-risk plaques (33.33 ％) and 16 cases with high-risk plaques (53.33 ％).In the control group,13 cases with low-risk plaques (43.33％),6 cases with middle-risk plaques (20.00％),11 cases with high-risk plaques (36.67％).The number of intraplaque hemorrhage were 18 cases (60.00％) in the observation group,and 8 cases (26.67％) in the control group.The number of fibrouscap rupture were 21 cases (70.00％) in the observation group,and 13 cases (43.33％) in the control group.Risk stratification of vulnerable plaques in cerebral atherosclerosis (U =-2.032,P =0.042),intraplaque hemorrhage (x2 =6.79,P =0.009) and fibrouscap rupture (x2 =4.34,P =0.037) in the observation group was higher than that in the control group.The number of inflammatory cells in plaques and the density of the new blood vessels in the observation group was (0.188 ± 0.265)Ktrans/min,which in the control group was (0.118 ± 0.183)Ktrans/min.The number of inflammatory cells in the plaque and the density of the new blood vessels in the observation group was higher than that in the control group (t =11.831,P =0.000).Conclusion Hyperhomocystinemia causes intraplaque hemorrhage,fibrouscap rupture,inflammatory cell activity and neovascularization in plaques,accelerates cerebral atherosclerosis and increases the incidence of ischemic stroke events.

Objective To observe the effect of fluvastatin on urinary albumin excretion rate(UAER)of microalbuminuria in type 2 diabetes patients.Methods Type 2 diabetes patients with mieroalbuminuria were randomly divided into fluvastatin goup(n=126)and control group(n=129).Fluvastatin group was given fluvastatin 40 mg each night.Follow up was conducted for 1.5 years.The UAER and glomerular filtration rate(GFR)as well as blood lipid level before and after therapy were compared.Results UAER in fluvastatin group was significantly lower than that in control group[(59.6±10.5)vs(87.5±12.3)mg/min,P＜0.05]before therapy[(104.4±25.2)vs(110.6±19.7)mg/min,P＜0.05],which was independent of its lowering-lipid effect.But GFR had no signifimicroalbuminuria which is independent of lowering-lipid effect in type 2 diabetic nephropathy patients and delay the progress of diabetic nephropathy.