Objective To investigate the effect of intramedullary stabilization of tibiofibular fractures with titanium elastic nails (TENs) in children .Methods Totally 59 children patients with tibiofibular fractures ,from January 2008 to November 2013 ,were stabilized with TENs in the C‐arm fluoroscopy in our hospital .All patients were followed up after surgery ,including fracture heal‐ing ,wound conditions ,limb length ,range of motion of knee and ankle ,gait ,etc .Results All of the 59 cases were followed up for 6-36 months ,average 16 months .All fractures were healed in good alignment .There were no postoperative complications such as infections ,swelling and pain at the end of the nails ,TENs broken ,tibial epiphysis injuries and unnormal function of the lower limb joint .According to the Flynn evaluation standard ,excellent result were observed in 49 cases ,good in 10 cases ,the excellent and good rate was 100% .Conclusion Intramedullary stabilization with TENs can achieve effective fixation in the treatment of tibiofibular fractures ,it has advantages of micro‐trauma ,tiny tissue damage ,little influence on blood circulation at the fracture site ,good stabili‐ty ,rapid healing ,short hospital stay and few complications .

Objective To explore the effect of cosmetics on patients who have facial telangiectasis. Methods We treated 252 cases of facial and nasal telangiectasis with Vbeam laser machine made in USA. The wavelength is 595 nm. We chose proper pulse width and energy output according to the vascular diameter. The handle shaft should focus on the treatment locations when we treated the patients. The skin eruption turned grey and the telangiectasis disappeared after laser irradiation. The stellate telangiectasis and nasal telangiectasis could be cured after 1～7 times of laser irradiation. The puactate or filamentous telangiectasis and erythema, heliotrope patchy telangiecatasis could be cured after 1～3 times. The treatment interval was 1～2 months. Results All of the 252 cases of facial telangiectasis were cured. The cure rate was 100 %. The skin reaction to the laser irradiation was slight. 30 % of the patients showed hyperpigmentation, which could disappear spontaneously after 1～6 months. In addition, we found patients' faces become more smooth and less wrinkles. Conclusion Satisfied effects are archieved in facial telangiectasis with Vbeam laser machine. This treatment has no scar and no recurrence with only slight skin reaction. And the skin becomes smooth and less wrinkles. Therefore, it is a good choice to treat facial telangiectasis with Vbeam laser irradiation.

Objective To explore the surgical treatment of advanced rectal carcinoma in aged people. Methods The clinical data of 65 aged patients with advanced rectal carcinoma from 2000 to 2004 were analyzed retrospectively. Results All cases were Dukes D stage or accompanied with hepatic metastasis. Hartmann's operation was performed in 26 cases, single lumen sigmoidostomy in 11 cases, double lumen sigmoidostomy in 11 cases and resection of hepatic metastatic cancer in 12 cases. Rectal upper arterial catheter chemotherapy was performed in 19 cases and hepatic arterial catheter chemotherapy in 15 cases. The 3-year survival rate of Hartmann's operation was 34%(9/26), and the average survival time was 20?3.17 months in the patients underwent rectal upper and hepatic arterial catheter chemotherapy, and 10?1.77 months in the patients who could not be treated surgically(P

Objective To explore the diagnosis and treatment efficacy of bronchobiliary fistula due to hepatic cystic echinococcosis.Methods A retrospective evaluation of 39 patients with BBF was performed during 1992 to 2012.We divided the 39 patients into group A treated before 2001 and group B after 2002.A retrospective analysis was made.Results There were three deaths among the 39 BBF patients due to hepatic hydatid disease.The cause of death was septic shock due to severe infection.There were no statistical differences in the basic factors,age (t =0.84,P =0.554),gender (P =1.0),and sputum volume (t =0.98,P =0.703),hydatid diameter (t =1.11,P =0.406),operation time,chest infection (P =1.0),mortality (P =0.235) between the two groups (P ＞ 0.05).While postoperative length of stay(t =7.64,P =0.000),postoperative complications of residual cavity (P =0.001),length of tube drainage(t =6.747,P =0.01),recurrence of bronchial fistula (P =0.022),pleural dissemination (P =0.018),reoperation rate (P =0.049) were all in favour of group B (P ＜ 0.05).Conclusions Surgery is the choice of therapy for BBF due to hepatic hydatid disease,and one-stage procedure is expected to achieve the best outcomes.

Objective To explore a more effective way to enhance the clinical efficacy of cluster immunotherapy for perennial allergic rhinitis. Methods A total of 60 perennial allergic rhinitis patients were evenly randomized into treatment goup and control group. The two groups were given cluster immunotherapy, and the treatment group was given daily vesiculating moxibustion additionally . Before and after treatment, the scores of traditional Chinese medical constitution and the rhinitis quality of life ( QOL) were observed, and one year after treatment, the therapeutic effect and safety were evaluated. Results ( 1) One year after treatment, the treatment group showed better total clinical efficiency than the control group ( 96.67% vs 80.00%, P<0.05). ( 2) After treatment, the average scores of Qi deficiency constitution, yang deficiency constitution and special constitution were significantly lower than those before treatment in the treatment group ( P<0.01). The improvement of Qi deficiency constitution and yang deficiency constitution in the treatment group was superior to that in the control group ( P<0.05). ( 3) The total QOL scores and the scores of each dimension of QOL scale were improved in both groups, and the differences were significant except for the emotion dimension ( P<0.01). Insignificant differences were shown between the two groups after treatment ( P>0.05). ( 4) Two cases had grade 1 general adverse reaction and 5 cases had local adverse reaction during cluster immunotherapy. During vesiculating moxibustion, 3 cases had blistering and the blistering disappeared after symptomatic treatment. Conclusion Daily vesiculating moxibustion combined with cluster immunity therapy is effective for the treatment of allergic rhinitis, showing good effect on improving Qi deficiency constitution, yang deficiency constitution and special constitution as well as the quality of life of the patients.

Objective To observe the effect of continuous incision infusion different concentra-tion of ropivacaine for postoperative analgesia after radical mastectomy.Methods One hundred pa-tients under radical mastectomy,aged 40-70 years,ASA Ⅰ or Ⅱ,were randomly divided into four groups (n =25 each):0.2% (group R1),0.3% (group R2),0.4% (group R3)ropivacaine incision continued infiltration group and patient-controlled intravenous analgesia (group PCIA)as control group.VAS pain scores,sedation Ramsay score and side effects were recorded at each time point in rest and turning over 90°,2 h (T1 ),4 h (T2 ),8 h (T3 ),12 h (T4 ),24 h (T5 ),48 h (T6 )after the operation.Results VAS scores in group R1 at T1-T6 in rest and turn over 90°were significantly high-er than that of group PCIA (P <0.05).There were no significant differences among the group PCIA, group R2 and group R3.Sedation score in PCIA group was significantly higher than that in the other three groups (P <0.05),and the adverse reactions,such as nausea and vomiting,in group PCIA (2 cases)were more serious than that in the other groups (0 cases ).There were no significant differences among the other groups.Conclusion Ropivacaine plays an effective role in infiltration an-algesia when its concentration reaches 0.3% subcutaneous after radical mastectomy.

Objective To investigate the viability of analysis of hemodynamic changes with color Doppler flow imaging in the prediction of acute rejection in transplanted liver.Methods Sixty-eight patients enrolled in the study were categorized into three groups:transplanted liver without acute rejection [rejection activity index(RAI) 0-3,n =24],transplanted liver with mild acute rejection (RAI 4-5,n =23),transplanted liver with moderate and severe acute rejection (RAI 6-9,n =21).All the patients were confirmed by pathology.The color Doppler flow imaging were performed in all the patients within 24 hours and 1 week after biopsy.Results In transplanted liver with moderate and severe acute rejection,the peak systolic velocity of portal vein (PV-PSV) was (31.4 ± 14.1)cm/s,significantly lower than that in transplanted liver without acute rejection,which was (45.1 ± 17.7)cm/s (P ＜0.05).A week later after steroid therapy,the PV-PSV in transplanted liver with moderate and severe rejection was increased to (46.7 ± 21.8)cm/s(P ＜0.05).Patients with acute rejection were associated with the decrease of the PVPSV (P ＜0.05).Conclusions The decrease of PV-PSV may have some clinical value in evaluation the acute rejection in transplanted liver.

Objective To explore the ways to decrease the postoperative complications of pancreaticoduodenectomy. Methods Thirty-four patients who underwent pancreaticoduodenectomy between January 1998 and December 2004 were reviewed retrospectively. A duct-to-mucosa pancreaticojejunostomy was performed mostly for patients, and an end-to-end pancreaticojejunal invagination for 5-patients with a soft pancreas and a small pancreatic duct. The end-to-side hepaticojejunostomy and the Roux-en-Y reconstruction of gastrointestinal continuity were performed for all patients. Results The hospital mortality was zero. The postoperative complications occurred in the form of wound infection was 4(12%), delayed gastric emptying was 1(3%), pneumonia was 1(3%), intra-abdominal collections was 1(3%) and pancreaticojejunostomy leak was 1(3%). In 1 patient with pancreaticojejunostomy leak, the closure was achieved with the conservative treatment. Intra-abdominal bleeding, intra-abdominal abscess and other anastomotic leakage were not seen in any of patients. The median follow-up was 21 months (ranging from 6 months to 5 years), none of patients had clinical evidence of steatorrhea, bile reflux gastric disease, anastomotic ulcer, retrograde cholangitis and dumping syndrome, there was no new case of diabetes. Conclusions Proper method of reconstruction produces encouraging results in decreasing the complications after pancreaticoduodenectomy.

AIM: To investigate the differentiation from adult rat and human bone marrow mesenchymal stem cells (BMMSCs) into neuron with musk polypeptide (Mu-P).METHODS: Adult rat and human BMMSCs were induced with Mu-P.Neuron-specific enolase (NSE),neurofilament (NF),Nestin,glial fibrillary acidic protein (GFAP) were detected by immunohistochemistry.RESULTS: Simple methods with Mu-P induced adult rat and human BMMSCs exhibiting a neuronal phenotype,expressing Nestin at 3 hours to 5 hours,and expressing NE and NF at 5 hours to 7 days.But the neuron-like cells didn't express the glial astrocyte marker GFAP.CONCLUSION: Adult rat and human BMMSCs can be induced to differentiate into neurons with Mu-P.

Objective In children with neurogenic bladder and secondary vesicoureteral reflux , we ex-plore the differences of urodynamics between the children with and without detrusor overactivity (DO). The study is in order to provide theoretical support for clinical practice. Method From January 2013 to March 2016, 110 children with NB vesicoureteral reflux diagnosed by videourodynamics were recruited. There are 63 boys and 47 girls aged 4-12 years with mean of 7.5 years. According to presence of DO during the filling phase, the patients were divided into DO (n=32) and non-DO groups (n=78). The time of bladder ureter reflux perfusion and detru-sor pressure were recorded for calculation of bladder compliance when the reflux occurs in the two groups. Maximum cystometry capacity and maximum detrusor pressure were recorded for calculation of the bladder compliance at the end of filling in the two groups. According to the reflux flow level, patients were divided into mild reflux (Ⅰ-Ⅱdegrees), severe reflux (Ⅲ-Ⅴdegrees). The difference of reflux side of the two groups and reflux degree were an-alyzed. Result In DO group, bladder capacity and compliance were (107.5 ± 21.3) mL and (5.6 ± 1.8) mL/cmH2O, respectively, when bladder ureter reflux occurs. In non-DO group, the bladder ureter reflux bladder capac-ity and compliance were (124.7 ± 35.6) mL, (6.7 ± 2.3) mL/cmH2O. The two parameters were significantly differ-ent in both groups. In DO and non-DO groups, the detrusor pressure were (21.7 ± 8.3) cmH2O and (19.6 ± 9.2) cmH2O, respectively, which does not have any significant statistical difference. At the end of filling, bladder capac-ity and compliance in DO group were (198.7 ± 36.5) mL, (5.8 ± 1.9) mL/cmH2O. In non-DO group, bladder ca-pacity and compliance were (223.8 ± 40.2) mL and (6.5 ± 1.4)mL/cmH2O. In both group, there are difference. In DO group, there are 20 cases of unilateral reflux (63%) and 12 cases of bilateral reflux (37%). In non-DO group, there are 31 cases of unilateral reflux (40%) and 47 cases of bilateral reflux (60%). The reflux of the two groups are also serious. Conclusion Small bladder capacity and poor bladder compliance are the urodynamic characteris-tics of children with NB and secondary vesicoureteral reflux when DO occurs.