BACKGROUND:Current clinical studies seldom concern biomechanical properties of lateral plate combined with medial percutaneous lag screw. Moreover, effects of clinical application to distal tibial fractures are not investigated. OBJECTIVE:To explore biomechanical properties of lateral plate combined with medial percutaneous lag screw, and to analyze the repair effect on distal tibial fractures. METHODS:Six adult antiseptic tibia specimens were studied. Bone saw was used to make a bone defect in 1 cm length, which was fixed with lateral plate and lateral plate combined with medial percutaneous lag screw. Three point bending test, axial compression test and rotation test were performed. Clinical data of twenty cases of distal tibial fracture patients from the Department of Orthopedics of Hebei Medical University were analyzed and randomly divided into lateral plate groupand lateral plate combined with medial percutaneous lag screw group (n=10). Clinical repair effects were compared between the two groups. RESULTS AND CONCLUSION:(1) Biomechanical indexes of cadaver specimens: no significant difference in torsional strength was determined between the two groups (P> 0.05). Bending stress and axial displacement were significantly lower in the lateral plate combined with medial percutaneous lag screw group than in the lateral plate group (P< 0.05). (2) Repair surgery related indicators: operation time, intraoperative blood loss, length of stay and fracture healing time were significantly less in the lateral plate combined with medial percutaneous lag screw group than in the lateral plate group (P< 0.05). (3) Repair effects: There were nine cases of fracture healing in the lateral plate combined with medial percutaneous lag screw group 3 months after treatment. The total effective rate was significantly higher in the lateral plate combined with medial percutaneous lag screwgroup (90%) than in the lateral plate group (70%) (P<0.05). (4) These findings indicate that lateral plate combined with medial percutaneous lag screw has a unique advantage in resisting axial compression, torsion and bending. Its application to distal tibial fractures obtains ideal effects, can improve the clinical efficacy and stability.

Colorectal cancer is induced by multiple factors.Multiple genes should be considered for the research of colorectal cancer.Single nucleotide polymorphisms,a new tumor gene researching method,play a key role in colorectal cancer researching.Finding colorectal cancer special SNP is vital for selecting high risk population and predicting the risk of developing colorectal cancer.

Nearly every patient admitted into PICU is administered sedation and analgesia therapy.The precise control of the depth of sedation and the intensity of pain are often not well managed.Inappropriate treatment will cause more adverse effects.Self-assessment is considered the gold standard in pain rating,other complementary methods being the behavioural measures and the biological measures,that reflect the body's answer to pain.There is a growing need for reliable and valid sedation and pain instruments that can easily be incorporated into daily care.There are many methods for assessing pain and sedation in critical children,but none is completely accepted as an objective measure or suitable for all ages of children.The clinicians should choose appropriate assessment tools and even combine different tools according to the environment,condition and the characteristics of patients.

The study was designed to observe the effects of fructose- 1 ,6 - diphosphate (FDP) on the stressed patients who were supported with total parenteral nutrition (TPN) after gastrectomy.Twelve cases of patients with gastric cancer were randomly divided into two groups.The control group was supported by TPN,and the FDP group received TPN plus FDP.The resulshowed thatin FDP group the serum levels of cortisol and glucogon declined and the urine 3- methyl- histidine excretin decreased with a better cumulative nutrogen balance when compared with control group.It sug- gested that FDP may lessen the protein catabolism and improve the results of nu- tritional support in stressed patients after trauma or surgical operation.

It is still difficult to achieve optimal nutritional effect in the septic patient.The objectives of this prospective study are to determine the effect of increasing N intake on the metabolic response to TPN in the septic patient,containing either0 .2 5 g N/ (kg? d) or0 .35 g N/(kg? d) .On the high- but not the low- N intake there were further beneficial effects on net protein levels in blood and nitrogen balance.The results showed that TPN containing high N instake can further achieve nitrogen bal- ance in the septic patient,although it may stimulate the catabolism of protein and further evoke the stress to responses.

Gallbladder cancer is the most common malignancy of biliary tract with a very poor prognosis. The therapeutic strategy of gallbladder cancer has been improved in some aspects. Identifying the accurate stage is the basis of surgical treatment. Radical resection is the only choice of treatment which provides patients long survival. For most patients in T1a stage, simple cholecystectomy is adequate, but dissection of hepatoduodenal ligament should be added when the lesions located in neck and duct of gallbladder. Patients in T1b stage often need radical cholecystectomy. Radical cholecystectomy with Ⅳb and Ⅴ segmentectomy and lymphadenectomy of N2 nodes should be performed to patients in T2 stage. Extended right lobe resection can improve the prognosis of selected T3 and T4 patients.The effect of chemotherapy for gallbladder cancer remains unsatisfactory, and current chemotherapeutic regimens were based on 5-FU, gemcitabine or S-1. The effect of a new chemotherapeutic sensitization scheme with continuous infusion of somatostatin,epirubicin 5-FU/CF and cisplatin is under research, and the preliminary results are promising. Radiation shows some benefits to patients with gallbladder cancer, but its effects are still uncertain.

There are much more multidrug-resistant organisms (MDRO) in the intensive care unit than ever.If the doctors could distinguish the colonization from infection of MDRO,they can make right decision on the rational clinical use of antibiotics to reduce resistant organisms and nosocomial infection.However,it's a confused problem for clinicians to distinguish between colonization and infection.Bacterial culture combined with clinical symptoms and signs maybe helpful,but it is limited.There should be more objective indicators.This article was aimed to state the definition and relationship between colonization and infection,and how to determine the colonization and infection of MDRO.

Acute liver failure (ALF) is rare in children but carries high mortality.It can progress to multi-organ failure and death.The etiology,clinical manifestations,diagnosis and prognosis of pediatric acute liver failure (PALF) are different from that of adults,and vary with age.The classic adult symptoms are often absent in children and the clinical encephalopathy may not be present.Children correctly diagnosed with well-characterized causes of PALF may benefit from the early implementation of directed medical therapies.Early recognition,diagnosis,and identification of prognostic factors will help in optimizing treatment and selecting patients for liver transplantation or artificial support,and improved their survival chances.

Objective To explore the effect of emergency corpus luteum cystectomy for the prevention of persistent ectopic pregnancy(PEP).Methods The clinical data of 68 patients with ectopie pregnancy in emergency conservative operation were analyzed retrospectively.All patients were divided into the observation group(treated with corpus luteum cystectomy,40 cases) and control group (without corpus luteum cystectomy,28 cases).The declining of β-HCG,incidence rate of PEP were compared between the two groups.Results The incidence rate of PEP of the observation group was 0,which was obviously lower than that of the control group(10.7％) (x2 =4.47,P ＜ 0.05).Conclusion The emergency corpus luteum cystectomy can effectively prevent PEP and the operation is simple and convenient.

Recently,the Society of Critical Care Medicine and the European Society of Intensive Care Medicine sponsored a 19-member Task Force to update the definitions of sepsis and septic shock at the forty-fifth Critical Care Medicine Annual Meeting in February 2016.Owing to an increased understanding of the harmful systemic response to infection,members of the multidisciplinary task force proposed that sepsis now be defined as life threatening organ dysfunction caused by a dysregulated host response to infection.To standardize the assessment of organ dysfunction,the Task Force members propose that provider use the sequential organ failure assessment(SOFA) score and quick SOFA (qSOFA).Although the systemic inflammatory response syndrome(SIRS) standard has high sensitivity and low specificity,the mortality of sepsis in the world has decreased significantly in the past 20 years.With the gradual realization of sepsis 3.0,will SIRS really be completely out of the stage of history? The SOFA and qSOFA criteria is not suitable for children.The author thinks that SIRS standard still has its practical application value.We need further studies on how to improve the sensitivity and specificity of sepsis diagnosis at the same.We should continue to validate sepsis 3.0.