Objective To conduct a hiomechanical comparison of the four common internal fixation methods for the anterior eruciate ligament(ACL)avulsion fractures of displaced tibial eminence.Methods Sixteen fresh cadaver knee joints were used and randomized into four equal groups of four fixation methods:antegrade wiring group, retrograde wiring group,suturation group,and intramedullary screw group.The knee joint specimens were fixed at flexion of 30?and subject to continuous stretch stresses of 30 N,60 N and 90 N respectively on a material testing machine(MTS 858 Bionix test system,USA)which conducted a simulated Lachman test.The specimens were scanned at different angles by a three dimensional laser scanner.Data were recorded and processed by image software to es- tablish three-dimensional structure models of femur,tibia and knee joint.The test results were analyzed statistically on a computer.Results There were no obvious differences between each fixation group in the length change of ACL when the stresses were 30 N and 60 N(P＞0.05).Under 90 N stress,however,the mean length change between the femoral and tibial attachments of ACL was the smallest(4.8?1.7)mm(2.5 to 6.2 mm)in the suturation group(P＜0.05). There were no distinct differences between the intramedullary screw group and the retrograde wiring group in the changes of A CL shift(P=0.214).The average front shift in the retrograde wiring group was(6.2?1.2)mm(4.8 to 8.2 mm) and significantly smaller than that in the antegrade wiring group(P＜0.05).The antegrade wiring group made the largest average front shift under different stresses and its average front shift was(7.2?1.3)mm(5.6 to 8.7 mm). Conclusions The knee joint stability provided by the suturation fixation is distinctly better than that by the other three fixation methods.The antegrade wire fixation provides the poorest knee joint stability.There is hardly any difference between intramedullary screw fixation and retrograde wiring fixation.

ObjectiveTo study of the impact on dose distribution by electron width of energy spectrum and angular distribution using Monte Carlo simulation.MethodsThe simulated electron energy spectrum and angular distributions was as the input parameters and percentage depth dose (PDD) and offaxis curves were simulated by a modified PENELOPE code package. Results PDD and off-axis dose distribution curves are almost the same and are not sensitive to energy spectrum width and angular distribution with the exception of energy spectrum width of 2.5 MeV with obviously different curves.ConclusionsIn the situation of clinical treatment,spectrum and angular distributions can be ignored when their width are not very large.It is helpful to save about 9％ time by using monoenergy beams in treatment planning system development.

Objective To observe the transformation features of children with complete atrioventricular block(CAVB), and to improve the diagnosis and treatment of this disease.Methods Seventeen children with primary diagnosis of CAVB were reviewed by retrospective and follow-up study and the clinical characteristics, treatment schemes and prognosis were evaluated.Results Four cases of congenital CAVB lived normally without obvious symptoms in the tracing period from 6 months to 9 years;1 case had the onset of Adams-Stokes syndrome induced by diarrhea;3 cases of the CAVB caused by virus myocarditis turned into sinus rhythm after comprehensive therapy;2 cases persistently presented with the CAVB Complicated with enlarged heart;1 case gave up treatment after deterioration, and one case died.Three cases of temporary CAVB after the open heart operation turned to sinus rhythm in transitory time, while other two cases presented with permanent CAVB and treated with epicardium pacemaker,among whom one had the pacemaker replaced for one time in the 8-year follow-up,and the follow-up of other cases were intermitted.Conclusions The congenital CAVB in the study group with normal QRS interphase and no obvious symptom might not require treatment but follow-up is needed. While infants with heart malformation and wide QRS wave could not endure the low ventricular rhythm are in high risk. Virus myocarditis induced CAVB children tend to present the Adams-Stokes syndrome, and require effective treatments. Partial cases of the CAVB caused by open heart operation may turn to normal sinus rhythm in 2-4 weeks after surgery. cases has persistent CAVB for over 4 weeks, or Adams-Stokes syndrome onset after the surgery demand epicardium pacemaker treatment.

Objective To analyze and compare the clinical application values of procalcitonin (PCT),leukocyte count (WBC) and C-reactive protein(CRP) in elder patients with infection.Methods In patients(age≥ 65 yrs,axillary temperature ＞38.0℃)with infection or suspected infection,PCT,WBC,CRP and other bacteriological examination were performed.The electronic medical records from the HIS system of our hospital were analyzed retrospectively in combination with medical history.Results Of the enrolled 219 patients,65 ones were in control group,48 ones SIRS,51 ones sepsis and 55 ones MODS.There was a positive correlation between the level of serum PCT and the infection degree.The Spearman correlation coefficient was 0.706 (95％CI:0.616-0.797,P=0.000).Based on the highest Youden index (sensitivity+specificity-1),the best cutoff point of diagnosis for PCT was ＞0.341 μg/L (sensitivity 84.5％,specificity 55.8％),a analysis of receiver operating characteristic(ROC) curve about PCT,WBC and CRP was carried.Area under the curve (AUC) of PCT to controlled infection was 0.916 (95％CI:0.864-0.967,P=0.000).Based on the highest Youden index (sensitivity+ specificity-1),the judging threshold of PCT to infection controlled or not was 0.73 μg/L (sensitivity 84.6％,specificity 88.0％).PCT level after treatment ＞0.73 μg/L showed the uncontrolled infection,＜ 0.73 μg/L controlled.Conclusions PCT has a higher specificity for elder patients with infection.The variation of PCT level can guide the application of antibiotics,avoid abuse and decrease the occurrence of drug-resistant bacteria.

Objective To investigate the influence of factors related to metabolic syndrome(MS)on the outcome in subjects without diabetes mellitus in a community.Methods A two-year follow-up study was conducted in 885 subjects who were enrolled in the epidemiologic survey carried out in Pingliang Community, Shanghai in 2002.Oral glucose tolerance test,lipid prefde,blood pressure(BP),body mass index(BMI),waist and hip circumferences were measured.Results (1)The baseline of BMI,fasting plasma glucose(FPG),2h plasma glucose after glucose loading(2hPG),BP,triglyceride(TG)in the subjects with impaired glucose regulation(IGR)increased significantly as compared to those with normal glucose regulation(NGR)(all P

Objective To investigate the supply of iodized salt in non-excessive iodine counties and iodine-free salt in excessive iodine counties at household level in Jiangsu Province so as to provide a basis for the prevention and control of iodine deficiency disorders(IDD).Methods According to the National Iodine Deficiency Disorders Monitoring Program(Trial),county(city,district) was taken as a elementary sampling unit in Jiangsu Province.Townships(towns) and administrative villages were selected by systematic sampling and random sampling in every county and households were chosen by random sampling to collect their edible salt samples.The salt iodine content in non-and excessive iodine regions was detected by direct titration method and semi-quantitative method,respectively.Results All 30 840 salt samples were collected from 106 non-excessive iodine counties,and qualified iodized salt was 30 303 copies,iodine-free salt 199 copies.Weighted by the population of counties,the rate of iodine-free salt was 0.71％,the coverage rate of iodized salt accounted for 99.29％,out of which,98.93％ was qualified and the consuming rate of qualified iodized salt was 98.23％.All 1296 salt samples were collected in 5 counties with excessive water iodine content and the coverage rate of iodine-free salt was 98.99％ (1283/1295).Conclusions The national targets for preliminary elimination of IDD have been achieved in regions of nonexcessive and excessive iodine of Jiangsu Province.But it still should be strengthen the management work of iodinefree salt in excessive iodine counties and iodine saft in non-excessive iodine counties.

Objective To explore the efficacies of Yoga on neurosis patients. Methods A total of 102 neurosis inpatients were divided into a study group and a control group. The patients in the control group were in treatment only using drug. The patients in the study group were guided to practice the Yoga exercise for 1 month in addition to the treatment of drugs. The efficacies of Yoga were surveyed by NOSIE (Nurses' Observation Scale for Inpatient Evaluation) and HAMD (Hamilton Depression Rating Scale) before and after the exercise. Results After 1 month of exercise in the study group, the NOSIE results showed that, scores of social ability (37.75±2.23), social interesting (17.54±5.14), personal health factors (28.37±3.13) were higher than those before Yoga exercises, especially the score of social interesting was higher than that before Yoga exercises (P<0.01). Scores of irritability, delay and depression factors were lower than those before Yoga exercises (P<0.01). Compared with the control group, there were significant differences in the decrease of the scores of HA MD and NOSIE (P<0.01). Conclusions Yoga is beneficial to body function, psychological function and social function of neurosis patients.

AIMTo approach the protective effect of low dose gentamicin against high ototoxic dose of gentamicin.

METHODSThe guinea pigs were randomly divided into four groups: control group, low dose group, low dose protective group and high dose group. Each group received multiple intraperitoneal injections of gentamicin sulphate within different durations. Auditory brain stem response (ABR) was examined one day previous to the first and 24 h after the final injection respectively. The bulla was taken out so that the content of NO, MDA and the activity of LDH in cochlear were determined.

RESULTSThe threshold of ABR was significantly lower in low dose protective group compared with high dose group (P < 0.01). The content of NO (15.86 +/- 1.98 nmol/mg pro) and MDA (19.14 +/- 0.96 nmol/mg pro) in homogenate of high dose group was significantly higher than that of control group, low does group and low does protective group (P < 0.01). The increase of the content of NO and MDA induced by high dose GM could be significantly decreased by low dose GM administration previous to high dose injection (P < 0.01). The activity of LDH in homogenate of high dose group was significantly higher compared with control group, low dos group and low dos protective group (P < 0.01). There was no statistically significant difference of content of NO and MDA among control group, low does group and low does protective group.

CONCLUSIONThe protective effects resulting from previous low dose administration to high dose injection of GM may be related to the decrease of content of NO and MDA and activity of LDH both of which induced by high dose GM.

Animals ; Cochlea ; metabolism ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Female ; Gentamicins ; administration & dosage ; adverse effects ; Guinea Pigs ; Hearing Loss ; chemically induced ; prevention & control ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism

BACKGROUND: It is found reported that polymorphism of Fok 1 restriction endonuclease cut site on exon 2 of 5' end start codon of 5' end start codon (SC), which affected the structure of VDR amino acids,and was relative related to bone mineral density(BMD).OBJECTIVE: To analyze the association between Vitamin D receptor gene (Fok 1) polymorphisms and osteoporosis in the elderly men.DESIGN: case-controlled trialstudy.SETTING: Institute of Gerontology, Chinese PLA General Hospital and Department of Endocrinology,Second Artillery General Hospital of Chinese PLA.PARTICIPANTS: A total of 26 elderly men with osteoporosis at out-patients clinic of Chinese PLA General Hospital and Department of Endocrinology,Second Artillery General Hospital of Chinese PLA from January 2002 to June 2002 were selected involved as osteoporosis case group,with and the average age of was (70±5) years, and BMD in osteoporosis group was 2.0-2.5 SD lower than 2.0-2.5 SD of the peak of BMD. Totally 66 healthy men with average age of (70±5)years were selected as control group during at the same time. All the subjects signed the informed consent,who were Beijing inhabitants of Han nationality, and there was no blood relationship among them.METHODS:VDR-Fok1 genotypes in both groups were detected with by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),and distributiondistribution of VDR-Fok 1 genotypes were analyzedanalyzed.MAIN OUTCOME MEASURES: distribution Distribution of VDR-Fok1genotypes in both each groups.RESULTS: Totally 66 healthy elderly men and 26 elderly men with osteoporosis entered analysis of results. The frequencies of FF, Ff and ff genotype were found to be 42%, 42% and 15% in control group, and 15%,50%,35% in osteoporosis group, respectively,and there was significantly different between two groups(x2=12.078,P ＜ 0.01).Frequency of allele were significantly different between control group and osteoporosis group (64%,36% vs 40%,60%, x2=8.232,P ＜ 0.01).CONCLUSION: There is a significant difference in the frequency distrinution of VDR gene start codon polymorphism between healthy elderly men and those with osteoporosis.

The way of "extracting-salting-chromatography" was used to purify the phycoerythrin and phycocyanin from Porphyra yezoensis in process scale-up.First,by comprehensive comparison of efficiency,the Sephadex G-25 was selected from four resins (Sephadex G-25、G-100、S-300 and CL-6B) as the best choice used in crude extract desalting of phycobiliprotein.Then the preparation process of phycobiliprotein was scaled-up with raw material(Porphyra yezoensis) increased from 1g to 20g,and finally to 400g.The results indicated that the yields of purified phycoerythrin and phycocyanin (absorption spectra purity above 3.2) increased during according to process scale-up,with 0.323% phycoerythrin and 0.148% phycocyanin obtained from 400g frozen Porphyra yezoensis blades respectively.It is no doubt that the process involved in the experiment is a potential way for large scale preparation of phycobiliproteins of high purity.