Fracture healing consists of four stages: hematoma and inflammation, granulation tissue formation, membranous and endochondral ossification, and remodeling. During these stages, the pathological changes are continuous and overlapping and numerous inflammatory factors and growth factors play a central role in the tissue regeneration and ossification. The fracture will eventually reach primary bone healing or callus healing depending on the stability of fracture site after treatment. The delayed union and nonunion can be assessed according to the treatment time, clinical examination, radiology and biomechanical testing. It is important to understand the differences between hypertropic and atrophic nonunions and the reasons that lead to nonunion. At last, methods to promote fracture healing are summarized and classified into four groups: biological, systemic, mechanical and biophysical ones.

Acute compartment syndrome (ACS) is still an emergent situation in traumatic orthopaedics. Its pathophysiologic mechanism and treatment principles have already been recognized and established widely. The main factors which affect the prognosis are early diagnosis and timing of surgical treatment. This review analyzes the methods of clinical and instrumental diagnosis,rectifies some misunderstandings in clinical evaluation and makes suggestions on appropriate monitoring.

Objective To observe the efficacy of treatment of cirrhosis ascites with integrated traditional Chinese medicine and western medicine. Methods All patients were randomly divided into a treatment group (27 cases) and a control group (25 cases). Patients in the treatment group were treated with integrated traditional Chinese and western medicine, while patients in the control group were treated with western conventional therapy. Resulta The total effective rate in the treatment group was 96.3%, showing significant difference (P＜0. 05) contrasting 72% in the control group. Conclusion It is effective that treating cirrhosis ascites with integrated traditional Chinese and western medicine.

Adenocarcinoma ; diagnosis ; surgery ; Esophageal Neoplasms ; diagnosis ; surgery ; Esophagogastric Junction ; Humans ; Stomach Neoplasms ; diagnosis ; surgery

The doctor-patient relationship has become increasingly tense. The requirement of the society for physicians, especially surgeons is higher. Apart from fine professional skills, surgeons must learn some other skills, such as communication, the ability of self-decompression, and the awareness of public relationship to deal with inculpation from the media and society. The medical record is more and more important nowadays, surgeons should pay enough attention to it. The public misunderstanding of the medical profession will surely harm both doctors and patients in the end.
Adaptation, Psychological ; Attitude of Health Personnel ; Communication ; Digestive System Surgical Procedures ; Humans ; Physician-Patient Relations ; Physicians

Objective To observe the effect of interleukin-1β(IL-1β) on expression of Matrix Metalloproteinases 13 (MMP-13) in rat chondrocytes and its regulation of miR-27b. Methods Chondrocytes were extracted from 7 Wistar male rats. Expression of MMP-13 were examined by Western blot at 0 h, 24 h, 48 h after IL-1βstimulation. Differential miRNAs expression profiles were examined by miRNAs microarray. The most obviously down-regulated miRNAs were confirmed by quantitative Real-time PCR. Targeted regulation relationship between miR-27b and MMP-13 was set up by Luciferase re?porter gene experiments. Results Expression of MMP-13 in rat chondrocytes was increased at a timely dependent manner upon IL-1βstimulation(P<0.05);Microarray revealed 36 miRNAs whose expression changed, among which 6(miR-27b, miR-31, miR-26a, miR-26b, miR-23, miR-204)were especially obvious. Real-time PCR confirmed that miR-27b was the one whose expression level were most down-regulated. Transient co-transfection of miR-27b mimics with luciferase expres?sion plasmids resulted in significant repression of luciferase activity in rat chondrocytes (P < 0.05). Conclusion IL-1βstimulation result in down-regulation of miR-27b and up-regulation of MMP-13 expression. MiR-27b and MMP-13 show targeted regulation relationship.

Humans ; Stomach Neoplasms ; diagnosis ; therapy

ObjectiveTo study the influence of psychological intervention on anxiety and de-pression of patients before Mammotome minimally invasive biopsy system in resection of benign breast lump. Methods120 patients with breast lumps were divided into the experimental group and the control group with 60 cases in each group. The psychological intervention was used in the experimental group be-fore the surgery, including psychological cognition, psychological guidance and support, family support, etc,and the routine nursing care was given to the control group. SDS and SAS were used to evaluate the psy-chological state of the two groups before surgery using χ2 test. ResultsThe anxiety and depression score in the experimental group was significantly lower than that of the control group. ConclusionsThe psy-chological intervention before Mammotome minimally invasive biopsy system in resection of benign breast lump can effectively ameliorate the anxiety and depression of patients.

This paper is to study the inhibitory effect of water soluble polymers--methyl cellulose (MC), hydroxypropyl methyl cellulose (HPMC), hydroxypropyl cellulose (HPC-M), poloxamer (F68) and polyvidon (PVP) on osthole (OST) crystallization and investigate the impact of polymer concentration and viscosity on crystallization behavior. Also, UV spectrophotometry method was used to determine the drug concentration at different time point to draw the OST concentration-time curve. Results show that HPMC has the most significant inhibition effect on OST crystallization, and drug concentration level is 1.61 times higher than that in control solution within 8 h followed by PVP (1.54) and MC (1.45) respectively. The kinetics of OST recrystallization can be described using first-order reaction, and the crystallization rate constants obtained by analyzing the regression equation indicate that HPMC-60SH-4000 and HPMC-60SH-10000 can greatly influence OST crystal formation. The dissolution rate of drugs precipitated from water-soluble polymer solutions is faster compared with controls in pH 1.2 HCl and pH 6.8 phosphate buffers, which demonstrated that water-soluble polymers can not only change the behavior of drug crystallization but markedly improve the dissolution rate of water insoluble drugs.

Objective To assess the feasibility and clinical effect of hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma.Methods Hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation was performed in 12 patients with advanced pancreatic carcinoma(pancreatic head,10 patients;pancreatic body,2 patients) between February 2002 and August 2004 in this hospital.Results All the operations were successfully accomplished.The operative time was 104~181 min(122?29 min),the operative blood loss was 45~152 ml(60?18 ml),and the length of hospital stay, 6~17 d(8.5?1.3 d).Postoperatively,the jaundice subsided gradually,and the patient's liver functions recovered to normal in 7~10 days.The abdominal pain disappeared in 3 patients and was obviously remitted in 7.Gastrointestinal dysfunction occurred in 2 patients and was cured with symptomatic therapy.Follow-up checkups with CT scannings in 10 patients for 6 months showed partial remission(PR) in 4 patients,no changes(NC) in 4 patients,and progressed disease(PD) in 2.Conclusions Hand-assisted laparoscopic internal drainage combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma is effective and micro-invasive.