Objective To explore the relationship between restoring Gissane angle and prognosis in calcaneal fracture surgery. Methods Forty patients with single side calcaneal fracture (SandersⅡ-Ⅲ), Gissane angle changed more than 15°and having performed open reduction and internal fixation with steel plate were enrolled. In them, 25 patients (experimental group) recovered Gissane angle in surgery referencing the healthy side with X-rays. Another 15 patients (control group) didn't recover Gissane angle. The ratio of calcaneum height and length was measured at 1 week after surgery. At 6 and 12 months after surgery, the function were valued by Maryland score. Results The ratio of calcaneum height and length in experimental group was significantly higher than that in control group:0.60± 0.04 vs. 0.55±0.05, and there was statistical difference (P<0.05). All the patients were followed up. At 6 and 12 months after surgery, the Maryland score in experimental group were significantly higher than those in control group:(88.9± 5.7) scores vs. (80.5±7.3) scores and (89.5 ±5.5) scores vs. (82.5 ±6.4) scores, and there were statistical differences (P<0.05). Conclusions Restoring Gissane angle is benefitial for prognosis. So in calcaneal fracture surgery, the Gissane angle should be recovered as much as possible referencing the healthy side.

AIM:To evaluate the effectiveness and safety between trabeculectomy with collagen matrix versus trabeculectomy with mitomycin C(MMC) for patients with primary open-angle glaucoma(POAG).METHODS:In this prospective randomized comparative study from January 2015 to December 2016.Thirty-two eyes presented with POAG were included in this study, 14 eyes treated by trabeculectomy with subconjunctival implant of collagen matrix (study group) and the other 18 eyes treated by trabeculectomy with mitomycin C.Postoperative IOP, the success rate of operation, number of postoperative glaucoma medications and postoperative complications were recorded.Each patient was followed up at least 6mo.RESULTS:The mean postoperative IOP was statistically different between the study group and the control group after 1d (P<0.05), while not statistically different at 1 and 1mo follow-up (P>0.05), and the mean postoperative IOP was statistically different between the two groups (P<0.05) at 3 and 6mo after surgery.There was no significant difference in the success rate of operation between the two groups at 6mo after operation (P>0.05).The IOP decreased at 1d after openations compared with before, kept stable at 1wk to 6mo.IOP of study group was lowen than control.IOP was controlled by glaucoma medications in the study group by 28% compared to control group by 33% at 6mo after operation, but there was no significant difference.There was no significant difference between the study group and the control group in complications (P<0.05).CONCLUSION:Trabeculectomy with collagen matrix implant is comparable to the use of MMC with a similar success rate in open-angle glaucoma and the range in reducing intraocular pressure was significantly higher than that of MMC and it can significantly avoid the occurrence of low IOP postoperatively, transient anterior chamber, conjunctival wound leakage complications has no advantages compared with the use of MMC.

Rifaximin as a representative of the non-absorbable antibiotics,has special effects and wide application prospects in treatments of acute intestinal tract infections,irritable bowel syndrome,inflammatory bowel disease,diverticulosis of colon,hepatic encephalopathy and so on.This paper reviews the advances on clinical efficacy and safety of rifaximin to provide reference for clinical use.

Objective To investigate the effect of all-trans retinoic acid (ATRA) on transforming growth factor β1 (TGF-β1)/Notch signaling pathway in injured podocytes induced by adriamycin (ADR) in vitro.Methods Podocytes cultured in vitro were randomly divided into normal group,model group,ATRA treatment control group,12-hour ATRA intervention group and 24-hour ATRA intervention group.Morphological changes were observed by using light microscope.The expressions of TGF-β1,podocin,Notch 1,Jagged 1 mRNA were evaluated through real-time polymerase chain reaction (RT-PCR) and the corresponding proteins were detected by using Western blot.Results (1) No obvious changes between normal group and ATRA treatment control group were revealed as the plump podocytes and distinct outline were found in light microscope,while podocytes in model group showed disordered arrangement,fuzzy boundary,atrophy,hypertrophy and increased cellular debris.Of note,the podocytes in 12-hour ATRA intervention group and 24-hour ATRA intervention group almost returned to normal.(2) In contrast with those in model group,the amounts of TGF-β1,Notchl,Jaggedl mRNA levels decreased in 12-hour ATRA intervention group (1.34 ±0.43 vs.4.16 ±0.31,1.67 ±0.2 vs.4.21 ±0.92,2.08 ±0.27 vs.5.14 ±0.63,q =23.83,11.45,19.67,all P ＜0.05) and 24-hour ATRA intervention group (1.22 ± 0.16 vs.4.16 ± 0.31,1.73 ± 0.53 vs.4.21 ± 0.92,2.08 ± 0.29 vs.5.14 ± 0.63,q =24.85,11.18,19.67,all P ＜ 0.05),and the differences were significant;similar trend was detected in the protein levels (1.04 ± 0.03 vs.4.31 ± 0.10,1.06 ± 0.04 vs.4.47 ± 0.24,1.07 ± 0.04 vs.4.20 ± 0.16,1.06 ±0.03 vs.4.31 ±0.10,1.07 ±0.03 vs.4.47 ±0.24,1.09 ±0.03 vs.4.20 ±0.16,q =163.50,69.61,90.36,162.50,69.40,89.78,all P ＜ 0.05),and the differences were significant;whereas the level of podocin mRNA (1.13 ±0.05 vs.0.40 ± 0.06,1.16 ± 0.03 vs.0.40 ± 0.06,q =36.50,38.00,all P ＜ 0.05) and protein (1.01 ± 0.01 vs.0.44 ±0.01,1.02 ±0.01 vs.0.44 ±0.01,q =180.25,183.41,all P ＜0.05) increased,and the differences were sig nificant.(3) The expressions of Notch1,Jagged1 mRNA were positively correlated with TGF-β1 mRNA (r =0.84,1.00,all P ＜ 0.05),but negatively correlated with podocin mRNA (r =-0.95,-0.94,all P ＜ 0.05) in model group.Conclusions ATRA might alleviate podocyte injury through cutting the expressions of TGF-β1,Notch1,Jagged1 and raising the expression of podocin in injured podocytes induced by ADR.

Objective To evaluate the changes of platelet aggregation rate and short-term prognosis after the application of colopidgrel with booster doses or replaced by ticagrelor for ACS patients with CYP2C19 medium-metabolized genotype). Method A total of 302 patients with medium-metabolized genotype were randomly divided into colopidgrel group (75 mg/bid) and ticagrelor group (90 mg/bid). Patients in both groups accepted other conventional treatments of coronary heart disease and accompanied diseases. The platelet aggregation rates and platelet inhibition rates were observed before and after the treatment. The incidence of adverse events was followed up within 1 m. Results After one-week treatment, the platelet aggregation rates of the inducement with 5 μmol/L ADP had statistical significance between colopidgrel group and ticagrelor group ( P = 0 . 019 ) and the platelet inhibition rates had statistical significance difference between the two groups (P = 0.000). No severe adverse events occurred within one-month follow-up and 10 dyspnea patients were all in ticagrelor group. Conclusions Compared with booster doses of clopidogrel, ticagrelor presents obvious inhibitory effect on platelet of patients with medium-metabolized of ACS but it increases the incidence of dyspnea.

To investigate the main factors influencing the quality of life and the relationship between quality of life and basic syndromes of traditional Chinese medicine (TCM) in patients with post hepatitic cirrhosis.

To meet with the need for culivating high-quality medical talents,the new teaching mode of problem-based learning (PBL) is attracting a lot of attention. Pathophysiology, which bridges basic medicine courses and clinical medicine courses,is more suitable for implementing PBL teaching mode. The teaching mode of incorporating case analysis is used into pathophysiology teaching by many ways is studied and an ideal result has been achieved.

Combining the reality of the exploration on humanistic quality education of medical students in our university in recent years,we propose that through setting up the system of "humanistic quality" as an elective course for the medical students,we project the pertinence and integrity of such education,and through strengthening the teaching administration of such elective courses and constructing the second classroom including background education and campus culture,we can further promote the humanistic quality education of medical students.

Objective To study the effects of valsartan and triptergium glycosides on the abnormal expression of connective tissue growth factor(CTGF) in rats with diabetic nephropathy. Methods Sixty male SD rats were randomly divided into normal control group,diabetic nephropathy group(DN group),diabetic nephropathy treated with valsartan group(VAL group) and diabetic nephropathy treated with triptergium glycosides group(TG group).Diabetic nephropathy model was established by intraperitoneal injection of streptozotocin(STZ) in DN group,VAL group and TG group.The rats were sacrificed after 2,4,8 and 12 weeks.The body weight,blood glucose,renal function and urinary albumin excretion rate(UAER) were measured,and the expression of CTGFmRNA in kidney was detected by RT-PCR. Results Compared with control group,the levels of blood glucose,blood urea nitrogen,serum creatinine and UAER were significantly increased in DN group(P