BACKGROUND:Schatzker V, VI fracture often causes the injuries to cruciate ligament, col ateral ligaments and meniscus. Moreover, the col apse and shifting were severe. The locking plate on one side cannot support the weight or obtain satisfactory reduction. OBJECTIVE:To compare the effects and stability of the dual-incision double-plate fixation and knee midline incision locking plate fixation in the treatment of Schatzker V, VI tibial plateau fracture. METHODS:A total of 76 patients with Schatzker V, VI tibial plateau fracture were respectively treated with locking plate fixation (n=38) and dual-incision double-plate fixation (n=38). Fracture reduction and healing were assessed using anteroposterior and lateral radiographs. Varus angle and medial caster angle of tibial plateau received biomechanical measurement. RESULTS AND CONCLUSION:Hospital stay and postoperative load time were significantly less in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). No significant difference in healing time was detected between locking plate fixation and dual-incision double-plate fixation groups (P>0.05). The number of complications, such as ankylosis, fracture delayed union, pin tract infection, delayed union, varus deformity, was significantly fewer in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). There were no significant differences in the fracture of loosening, knee instability, wound infection, skin necrosis, bone necrosis and nonunion between the dual-incision double-plate fixation and locking plate fixation groups (P>0.05). Postoperative Rasmussen classification was significantly better in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). Experimental results indicated that the clinical efficacy of the dual-incision double-plate fixation is superior to that of the anterior cruciate midline incision locking plate fixation in the treatment of Schatzker V, VI type tibial plateau fractures. The dual-incision double-plate fixation has more biomechanical stability.

Objective To investigate the clinical distribution and drug resistance of Pseudomonas aeruginosa in Ningbo area .Methods Pseudomonas aeruginosa strains isolated from the Affiliated Hospital of Ningbo University School of Medicine , Ningbo First Hospital , and Ningbo Ninth Hospital during January 2010 and December 2013 were collected .The clinical distribution of the strains was analyzed , and the antimicrobial susceptibility was determined with Kirby-Bauer method.WHONET 5.6 software was used for data analysis.Results A total of 1 757 Pseudomonas aeruginosa strains were collected in 4 years, accounts for 6.6% (1 757/26 544) of total bacterial strains isolated.Among 1 757 strains, 622 (35.4%) were isolated from intensive care unit ( ICU), and 322 (18.3%) from respiratory department.Most strains (1 045/1 757, 59.5%) were isolated from sputum specimens , followed by urine and succus prostaticus (148/1 757, 8.4%), bronchoalveolar lavage fluid (116/1 757, 6.6%), pus and wound secretion (237/1 757, 4.6%) .Strains were highly resistant to most commonly used antibiotics , and the resistance remained steady during four years.While the positive rates of carbapenem-resistant Pseudomonas aeruginosa (CRPA) were increased, which were 35.8%,45.8%,44.5% and 54.3% in each year.Conclusion Pseudomonas aeruginosa presents a wide clinical distribution and high resistance to multiple antibiotics in Ningbo area .

Background and purpose:In recent studies, the Notch-1 gene has been found to play an important role in the development of human glioblastoma.Short interfering RNA(siRNA) was used to silence the Notch-1 gene and block its expression.The objective was to determine whether siRNA targeting Notch-1 would inhibit the formation and growth of tumors in nude mice that modeled human glioblastoma.Methods:The human glioblastoma cell line TJ905 were first cultured and transfected with Notch-1 siRNA or nonsense siRNA by OligofectamineTM.The TJ905 cells were divided into 3 groups:the Notch-1 siRNA transfected group, nonsense siRNA transfected group and the control group.Each group's cells were subcutaneously injected into 5 nude mice.The nude mice(males, 3-4 weeks old) were given subcutaneous injections of either 0.2 mL of transfected siRNA or with normal TJ905 cells suspended at a 1?107 cells/mL concentration in a DMEM medium without serum.One week later, when the tumors were palpable, they were directly injected with the Notch-1 siRNA complex, nonsense siRNA complex, or PBS every 4 days for 20 days.Tumor sizes were measured every 3 days and calculated by the formula:volume(mm3) =1/2 length?(width)2.After a 20-day follow-up period, the mice were exterminated.Immunohistochemistry was used to determine the expression of Notch-1 gene.Results:The final tumor volume was less in nude mice injected with Notch-1 siRNA(1 203?206) mm3 compared mice injected with the nonsense siRNA injection(2 241?401) mm3, P

Objective:To investigate the relationship between the structure of TMJ and the craniofacial pattern,occlusion in ClassⅡ1mandibular retrusion children. Methods:TMJ MRI,lateral cephalometric were taken respectively from 30 ClassⅡ1 patients (14 boys and 16 girls,the average age was 10.8?1.1 years). The condyle position and disc position were measured. The correlation of condyle and disc position with craniofacial pattern and occlusion were analyzed metrically and compared with pearson test.Results:There were low positive correlation between MP-SN angle and anterial space. No correlation between posterior-anterior ratio and other data were found. The posterior facial height and Dp-Cc/Cs-Cc angle had low positive correlation. The anterior facial height and Dp-Cc/Cs-Cc、Ca-Ca'、Ca-Cp showed low negative correlation,and little correlation was found between condyle position and overbite and overjet. Overbite had no correlation with disc-condyle-fossa relationship. However,The positive correlation was found between the overjet. and Ca-Dm and Dp-Cc/Cs-Cc,and Pearson coefficient is 0.420 and 0.460.Conclusion:Vertical craniofacial patter has relation to forward displacement of condyle and backward displacement of disc. A deeper overjet is related with a higher risk of abnormal disc-condyle-fossa relationship.

This paper proposed the idea of building the applied anatomical experiment and research platform for surgical postgraduates with professional degree,establishing double-tutorial system and applying applied anatomical teaching in basis course learning,clinical skill training and research capacity cultivating after analyzing the reasons of poor applied anatomical background of surgical postgraduates with professional degree.These ideas were intended to improve the cultivation quality.

Objective To analyze the factors which influence the treatment compliance of hypertensive patients in health management. Methods Data of 6 325 hypertensive patients who received physical examination in our department were collected; 4 132 male cases and 2 193 female were included, their ages ranged from 28 to 84 years old;the average age was 61.2 ± 5.8 years. The patients of the health intervention group were randomly divided into 3 groups (group 1, group 2 and group 3). They were provided with regular health management (including weight management, catering management, sports management, medication management and monitoring of blood pressure), respectively, given different frequency of telephone follow-up (1 time per 2 months, 1 time per month, and 1 time per month), evaluating treatment compliance. All the results were analyzed and compared respectively according to the level of education, age and mental status. Data of 1 892 hypertensive patients who received outpatient services were enrolled as the control group. Among them, 4 132 were male and 2 193 were female, aged 28-84 years old, average (61.2 ± 5.8) years old. They received the traditional outpatient follow-up (outpatient service review and health education), their treatment compliance, timely correcting unhealthy lifestyle and medication method and self-testing blood pressure were evaluated. ANOVA and chi square test were used to analyze the treatment compliances and blood pressure control rates of the two groups. Result Compared with the control group, health intervention for hypertension patients could significantly improve the treatment compliance and blood pressure control rate(64.8%vs. 41.3%, 56.7%vs. 29.6%;χ2=2.827,1.382;P=0.032,0.007). Comparing the results of telephone follow-up frequency, the treatment compliance and blood pressure control rate of the 3 intervention groups were higher than those of the two other groups(77.3%vs. 65.4%, 51.7%,χ2=3.414,P=0.041;69.6% vs. 57.3%, 43.2%,χ2=2.763,P=0.028). The treatment compliance of patients with high education level was significantly higher than that of patients with low education level(68.7% vs. 59.1%, 46.4%,χ2=3.257,P=0.037;60.1%vs. 47.2%,32.8%,χ2=1.234,P=0.009). And the treatment compliance of patients with good mental state was significantly higher than that of patients with anxiety(Intervention group1:64.3%vs. 55.1%,41.9%,31.0%,χ2=2.257, P=0.016;59.4%vs.46.1%,20.9%,21.8%,χ2=3.34 5 P=0.021;Intervention group2:75.5%vs. 64.3%,51.8%,41.2%,χ2=2.932, P=0.030;68.3%vs.57.1%,39.2%, 32.1%,χ2=2.382, P=0.032;Intervention group3:86.5% vs.73.2%,62.6%,52.4%,χ2=2.435, P=0.026;75.2% vs. 68.0%,51.7%,43.3%,χ2=3.251, P=0.036). Conclusion More frequently follow-up can improve the treatment compliance and control rate of blood pressure in hypertensive patients;education, age and psychological condition are factors influencing treatment compliance in hypertensive patients.

Objective To investigate the relationship between infection of Helicobacter pylori (HP) and early renal damage in type 2 diabetes.Methods Materials of 223 customer cases who received physical examination in our department were collected and analyzed.They were divided into two groups:HP positive group and HP negative group according to the HP infection.The basic information,blood lipid,lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,erythrocyte sedimentation rate,and blood urea nitrogen and creatinine were compared between two groups,respectively.Results There was no significant difference in basic information,blood glucose,glycosylated hemoglobin and blood lipid (P ＞ 0.05).The results of lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,and erythrocyte sedimentation rate in HP positive group were higher than those in HP negative group (P ＜ 0.05).Conclusions The infection of Helicobacter pylori played a part in the early renal damage of type 2 diabetes.

Objectives: To investigate the distribution of common pathogens and their antibiotic resistance from patiens with catheter related sepsis (CRS).Methods: Catheter bacteria cultrure and antibiotic sensitivity test were performed from 69 patiens with CRS.Results: The common pathogens in CRS were fungi (41.1%),Gram-positive cocci (35.6%)and Gram-negtive bacilli (23.3%). Non-C. albicans species were major pathogen (19/30 stranins).The most strains were staphylococcus epidermidis in Gram-positive cocci and the most of them were Methicillin resistant.No vancomycin resistant strains were found. The Gram negative bacilli were often resistant to third generation cephalosporens.Conclusions: The dorminant pathogens of CRS are fungi and gram positive cocci and we should pay more attention to pathogens of resistence to antibiotics. In order to control CRS, CVC must be used reasonably and shorten the duration of retention.

Objective To investigate the accuracy of 320-slice row CT system for the detection of coronary artery disease(CAD)in high pre-test probability population without heart rate/rhythm control.Methods Thirty patients with a high pre-test probability of CAD underwent 320-slice row CT without preceding heart rate/rhythm control.Invasive coronary angigraphy(ICA)served as the standard reference.Data sets were evaluated by 2 observers in consensus with respect to stenoses≥50% decreased diameter.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and Youden index were analyzed;the impact of heart rate and calcification on image quality as well as diagnostic accuracy were also analyzed by Chi-square test Results Mean heart rate during scanning was 73.7±15.4 beats per min(bpm),and median(QR)of Agatston score of segment was 45.6(181).On a per-segment analysis,overall sensitivity was 96.1%(74/77,95%CI:89.03%-99.19%),specificity was 98.3% (337/343,95%CI:96.23%-99.36%),PPV was 92.5% (74/80,95%CI:84.39%-97.20%),NPV of 99.1% (337/340,95%CI:97.44%-99.82%)and the Youden index was 0.94.In both heart-rate subgroups(242 in heart rate＜70 bpm group,169 in heart ratet≥70 bpm group),diagnostic accuracy for the assessment of coronary artery stenosis was similar(P＜0.05).The accuracy and the quality score of the subgroup Agatston score≥100 were lower than that of the subgroup Agatston score＜100;however,the difiercnce of results between 320-slice row CT and ICA was not significant(P＜0.05).Conclusion 320-detector row CT can reliably detect coronary artery stenoses in a high pre-test probability population without heart rate/rhythm control.

Objective To determine the prevalence and treatment of chronic obstructive pulmonary diseases (COPD) among citizens in Ningbo. Methods A multi-stage stratified random sampling was applied to select 8 neighborhoods and 3 villages out of 7 districts in Ningbo, people who were older than or equal to 40 years were enrolled as subjects. Information on the prevalence rate and treatment conditions of COPD was collected through respiratory symptoms and treatment questionnaire and lung function screening. Results A total of 5865 people were screened, 5674 of them met inclusion criteria and completed questionnaire and lung function test. Among whom, 3044 people were men (53.6%, the average age is 55.7±11.4), 2630 women (46.4%, the average age was 55.3 ± 10.7);473 of them were diagnosed with COPD, the overall prevalence rate was 8.3%, including 354 cases who had never been diagnosed as COPD, accounted for 74.8% of the total cases diagnosed with COPD, mainly in stage ⅠandⅡof the disease. There were statistically significant differences between diagnosed and undiagnosed patients in the overall COPD group and among different gender groups ( stagesⅠandⅡ) and (stagesⅢandⅣ). Among the 473 COPD cases, 119 (diagnostic yield 25.2%) of whom had been diagnosed with bronchitis, only 48 (41.2%of the diagnosed) received drug treatment, only 13 patients were treated regularly with medication. Conclusion The overall prevalence rate of COPD among those over 40 years of age in Ningbo was quite high and mainly had stagesⅠandⅡof the disease. The number of the diagnostic yield and those who received regular treatment are quite low. The current situation of diagnosis and treatment are far from satisfaction, management of COPD should be strengthened to reduce the burden for family and society.