0.05).[Conclusion]Composite of heterogeneous deproteinized bone+autogeneous MSCs+rhBMP2 has the same ability of autogeneous bone graft to repair big experimental segmental tibia defect,thus it can be used as a scaffold in tissue engineering and for further study of immunogenicity and ossification ability.

Objective To investigate the effect of the personalized nursing care plan sheet for critically ill patients in the emergency intensive care unit. Methods The personalized nursing care plan sheet including general, personalized nursing issues and related measures was designed according to the standard from the nursing department. A group of 116 critically ill patients were divided into the observational group (58 patients) and control group (58 patients) from January 2012 to September 2014. The personalized nursing care plan sheet were applied for record and hand over in the observational group, while the unified problem statement nursing care plan sheet were used in the control group. The indicators of nursing quality were observed in the two groups and the nurses′satisfaction with the nursing care plan sheets was compared. Results The nursing quality in the observational group was higher than it in the control group with the lower incidence of failure rate in fundamental nursing, professional nursing, plan sheet, disease treatment and adverse event (32.76% vs. 62.07%,37.93% vs. 67.24%,29.31% vs. 68.97%, 20.69% vs. 53.45%, 10.34% vs. 72.41%, the χ2 values were 2.98, 2.98, 4.09, 3.46 and 6.60 respctively, P<0.05). The nurses′satisfaction with the personalized nursing care plan sheet was also higher than the unified problem statement nursing care plan sheet (P<0.05). Conclusion The incidence of nursing defects could be reduced by avoiding the incomplete nursing assessment and omitted nursing plan.

Objective To explore and evaluate the predictive value of the coagulopathy in patients with community-acquired pneumonia (CAP).Methods A retrospective study was carried out for investigating the prothrombin time (PT),activated partial thromboplastin time (APTT),plasma fibrinogen (FIB),thrombin time (TT),plateslets (PLT),D-dimer in 385 patients with CAP and 146 patients without infection,tumor,trauma,thrombosis as controls.All the patients were admitted to the Respiratory Medical Department from June,2010 to May,2011.The results of the aforementioned biomarkers were analyzed and compared between two groups.The Pneumonia Severity Index (PSI) was calculated to evaluate the correlation between coagulopathy and PSI.Results The comparisons of the abnormal rates of PLT,PT,APTT,Fib,D-dimer between the patients with CAP and the controls were 92/385 vs.9/146,39/385 vs.1/146,108/385 vs.7/ 146,331/385 vs.47/146,348/385 vs.5/146,respectively.The differences were statistically significant (x2 =21.608,13.557,33.747,149.280,365.619,respectively,P ＜ 0.01),while difference in TT was not statistically significant (8/385 and 0/146,x2 =1.839,P ＞ 0.05).The differences in abnormal rate of PLT,PT,D-dimer between high-risk group of CAP and the low-risk group of CAP were 45/148 vs.47/237,26/148 vs.13/237,146/148vs.202/237,respectively,and the differences were statistically significant (x2 =5.602,14.609,23.442,respectively,P ＜0.05),while there were no differences in TT,APTT,FIB between two groups (6/148 vs.2/237,47/148 vs.61/237,123/148 vs.208/237,x2 =4.614,1.635,1.638,respectively,P ＞0.05).D-dimer in patients with CAP was (3.8 ±6.1) mg/L,compared with the controls (0.3 ±0.1) mg/L,and D-dimer in high-risk patients with CAP was (7.5 ±8.3) mg/L compared with the low-risk group (1.6 ±2.0) mg/L (P ＜ 0.001).Rank correlation existed between D-dimer and PSI (r =0.798,P ＜ 0.01),while there was no correlation between PLT and PSI (x2 =6.040,P ＞0.05).Conclusions The coagulopathy commonly occurs in patients with CAP.D-dimer was significantly higher in patients with CAP.D-dimer level is positively correlated with severity of CAP.D-dimer can be an ideal biomarker to assess the severity of patients with CAP.

Aim To test the strength of Kraekow bilateral locking stitchfor tendon or ligament free end fixation and evaluate the stitch which wasused in reconstruction of cruciate ligament or secure fixation of soft tissue tobone. Methods Twenty-four specimens of patellar tendon free end, whichwere divided into 3 groups according 2 or 3 stitches and 6 subgroups ac-cording No1 Ethilon or 0.4 mm diameter stainless steel wire different suturematerials, fixed with Krackow locking stitch, were undertaken the tensiletest respectively, so as to find out the least stitches and efficient suture pat-tern. Results 2 Krackow locking stitches had more strength than that of0.4 mm diameter stainless steel wire, the fixation strength of 2 stitcheswhich used No1 Ethilon was more than 80 N, superior to the failure strengthof material itself, it still maintained the same strength if the first stitch wasacross the tendon tissuetransversely. There was no significant differencebetween 2 and 3 Krackow locking stitches in suture strength statistically, thefixation strength was superior to the suture material, it could reduce the'suture exposure when the first stitch is across the tendon tissue while main-tains a comparable strength to other suture. Conclusion If attempt to makea higher strength of suture, we should focus on selecting a stronger materialsor adding the suture materials in number rather than the stitch number.

Objective To evaluate clinical results of arthroplasty with the UNIVERS 3-D prosthesis in unstable shoulder arthritis. Methods 16 cases, which were 10 males and 6 females aging from 35 to 79 years (mean, 56.3 years), underwent shoulder arthroplasty with the UNIVERS 3-D prosthesis because of unstable arthritis. The patients were evaluated before surgery, at 12 months and the most recent follow-up with an average follow-up of 30.8 months(mean, 12-50 months) by Constant and normalised Constant score, and reviewed by the radiological analysis on preoperative and postoperative X-rays including AP, scapular and axillary views. Constant and normalised Constant score improvements at 12 months and the most recent follow-up evaluation were compared with the preoperative scores using paired-samples t test. Results 1) 8 out of 11(72.7%) cases with mild inferior humeral or glenoid exostosis. 2) The Constant score improved from 43.8?13(normalized Constant score, 51.36%?15.40% ) to 70.6?17.69(normalized Constant score, 86.44%?22.12%). The pain, activity, mobility and strength scores had been improved obviously. 3)Only one case had the radiolucent line around the uncemented humeral component with radiolucent index of less than 1. No any periglenoid component radiolucency, no shift or subsidence in humeral component, no migration and tilt in glenoid component, no change and loosening in the junction bolt between humeral stem and head. 4) Two cases were experienced postoperative complications including impingement of prosthesis with osteophytes, and PE-inlay loosening received revision surgery. Conclusion Excellent clinical results can be obtained by the shoulder arthroplasty using the UNIVERS 3-D prosthesis with low incidence of radiolucency and postoperative complication.

Objective To observe the effect of basic fibroblast growth factor on ChAT expression in neurons after tractive spinal cord injury in rats.Methods The animal model of tractive spinal cord injury in 36 SD rats was established.The bFGF-treated rats(n=18) received 20 ?l bFGF solution containing 20 ?g bFGF into subarachnoid cavity immediately,or at 1,2,3,4,8,12 and 24 h after animal model establishment,while the saline-treated rats(n=18) received the equal volume of normal saline at the same time.Another 6 normal SD rats underwent no treatment as normal controls.All rats were killed on postoperative day 4,7,14.The choline acetyltransferase(ChAT) were detected by immunohistochemistry preoperatively and on day 4,7,14 after spinal cord injury.Results The number of neurons positive of ChAT decreased gradually after tractive spinal cord injury.After bFGF treatment,positive neurons of ChAT increased in number,with significant difference between the bFGF-treated group and saline-treated group(P

Treating from liver is an important thought to treat esophageal cancer.Regulating the liver has very important significance in the process of treating esophageal carcinoma,which embodies at regulating liver is the key of soothing emotional injuries of esophageal carcinoma,removing esophageal pathology product and coordinating rising-descending function of spleen and stomach,and improving accompainedg symptoms of esophageal cancer.The thought of treating from liver should be used throughout the whole process of the treatment.So we must pay morn attention to regulate the liver and prevent liver injury during the differentiation and treatment of esophageal carcinoma.

Objective To evaluate clinical results of arthroplasty with the UNIVERS 3-D shoulder prosthesis in post-traumatic gleno-humeral arthritis. Methods A total of 54 cases (age range of 31-84 years, mean 67.07 years) with post-traumatic gleno-humeral arthritis were treated by the arthroplasty with the UNIVERS 3-D prosthesis. Constant score and normalised Constant score were used to strictly evaluate the preoperative function of 45 cases, of which 30 cases were reviewed by Constant score and normalised Constant score postoperatively with an average follow-up of 12-68 months. Of all, 44 cases were strictly followed up in respect of preoperative and postoperative X-ray including anteroposterior, axial and Y-shaped positions. Results Compared with the pre-operation, there was a significant increase in post-operative pain, activity, mobility and strength as well as the postoperative Constant score and normalized Constant score. Total shoulder arthroplasty (TSA) provided better score for daily life and mobility than hemiarthroplasty, with a significant difference (P

Objective To observe the effects of basic fibroblast growth factor on c-fos gene expression in spinal cord neurons of rats after tractive spinal cord injury. Methods The animal model of SD rats with tractive spinal cord injury was established through tracting T_ 13-L_2 spine longitudinally with a special spinal tractor that was put on parapophysis of T_ 12-L_3 vertebrae after exposing T_ 13-L_2 spinal cord via dual laminectomy, meanwhile spinal cord function was monitored by cortical somatosensory evoked potential (CSEP). Forty model rats were randomly divided into 2 groups, the bFGF treatment group (n=20) with bFGF injection into the subarachnoid cavity and the control group (n=20) with saline injection. Five SD rats without any treatment served as normal control. The c-fos gene expression was detected with immunohistochemistry and analyzed quantitatively with image system of computer. Results The c-fos gene expression in tractive spinal cord injury was higher than that in normal control group, especially increased markedly in damaged neurons. The peak value of c-fos gene appeared in 2 h after the injury, but c-fos level in the bFGF treatment group was lower evidently than that in the control group at the different sacrificed time (P

Objective To investigate the effect of emergency case video segmentally introduction combining with simulation in cultivation of undergraduate nursing students′skills of trauma management. Methods A group of 55 undergraduate nursing students, recruited in the control group from September 2013 to April 2014, were instructed by traditional teaching method, the trauma management skill was delivered by lecture, video and group based practice. Another 50 undergraduate nursing students, recruited in the observation group from September 2014 to April 2015, were located in the simulation group, while the key point of trauma management was segmentally introduced by emergency case video, the skill of trauma management was delivered by lecture and video, a multiple injury case scenario was used for group practice. The score of the practice test and the evaluation of the teaching were compared among the two groups. Results The students in observation group demonstrated more skilled trauma management compared with that in the control group (90.42±8.50 vs. 84.68±8.77, t=3.56, P<0.05). The students in observation group presented significantly higher satisfaction with the teaching, improving study interesting 93.33%(56/60), promoting the theory knowledge deepen 91.67%(55/60), improving the ability of thinking and observation 95.00% (57/60/) , improving the ability of analyzing and solving problems 100.00% (60/60), enhancing the ability of independent learning 96.67%(58/60), while in the control group, they were 76.36%(42/55), 69.09%(38/55), 65.45%(36/55), 69.09%(38/55) and 80.00%(44/55), the differences between the two groups were significant (χ2 =2.30-4.40, P < 0.05). Conclusions Application of emergency case video segmentally introduction combining with simulation provided more opportunity to the undergraduate nursing students to apply relevant knowledge in analyzing and dealing with trauma cases, which contributes to the improvement of undergraduate nursing students′ skills of trauma management.