Objective To investigate the therapeutic effect of two-stage delayed open reduction and internal fixation on Pilon fractures.Methods The clinical data of 36 patients(26 males and 10 females;aged 18-57 years with a mean of 38.5 years;9 patients suffered from open fractures and 27 with closed fractures;25 combined with fibular fractures) with monolateral Pilon fracture hospitalized in succession from Jan.2001 to Oct.2006 were analyzed retrospectively.According to the Ruedi-Allgower classification,there were 6 cases with type Ⅰ,21 with type Ⅱ and 9 with type Ⅲ fracture.All patients underwent temporary fixation with calcaneal traction or plaster slab for 7 to 14 days(mean 9.8d),and then they were treated with delayed surgery when the soft tissue injuries subsided.Ankle functions were evaluated to assess the clinical outcomes,and complications were documented for further analysis.Results Follow-up was performed for 19 to 34 months(in mean of 28 months).Based on the Mazur classification,the ankle function in 13 cases was excellent,17 as good,4 as fair and 2 as poor,with a satisfactory rate of 83.3%.Postoperative complications included 2 cases of superficial incision infections,2 of skin slough and 19 of articular degeneration.Conclusion Two-stage delayed open reduction and internal fixation is a reasonable and effective procedure in treating Pilon fractures with advantages of few complications and satisfactory ankle function.

Objective To improve the therapeutic efficacy of cervical spondylotic myelopathy (CSM) and reduce the complications by anterior cervical locking plate system (ACLPs).Methods 78 patients with CSM were treated with ACLPs.Thoughtful preparation and careful observation were given before and after the operation.Result All the cases obtained excellent results postoperatively according to the JOA score system except one dead.Conclusion ACLPs is a promising method for the treatment of CSM;careful preoperative preparation and postoperative observation can improve the efficacy and reduce the complications.

BACKGROUND:Lumbar fusion is a conventional effective measure to treat spondylolisthesis, spinal stenosis or with deformity. Bilateral pedicle screw fixation is recognized as the standard treatment for various spinal disorders, and has biomechanical and clinical advantages. OBJECTIVE:To evaluate the effects of bilateral pedicle screw fixation in the repair of lumbar disc herniation to restore disc height from the angle of imaging. METHODS: Clinical data of 42 patients with lumbar disc herniation were retrospectively analyzed. They al received bilateral pedicle screw fixation. Pain was evaluated before implantation, immediately and 1 month after implantation using Japanese Orthopaedic Association score of lower back pain and visual analog scale score. X-ray including anteriorposterior and lateral films of lumbar spine and MRI were used. CT was utilized to verify screw placement conditions and complications. RESULTS AND CONCLUSION:A total of 42 patients were folowed up for 3-6 months. Compared with pre-implantation, Japanese Orthopaedic Association score and visual analog scale score were significantly improved immediately after implantation (P < 0.01). There was no significant difference in Japanese Orthopaedic Association score between 1 month and immediately after implantation (P > 0.05). The height of intervertebral discs was significantly higher immediately and 1 month after implantation than pre-implantation (P < 0.01). The symptoms were lessened after fixation in al cases, and their qualities of life elevated. At 1 month, X-ray films and CT images revealed that no screw loosening, breakage or displacement occurred. The height of intervertebral discs was perfectly restored. No adverse events appeared in patients. These data indicate that bilateral pedicle screw fixation for lumbar intervertebral disc herniation can effectively restore the height of intervertebral discs, improve clinical symptoms and have biological and clinical superiority.

Objective To explore the expressions of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)and apoptosis related genes caspase-3,Bax and bcl-2 in placenta,and their associations with the pathogenesis of preeclampsia.Methods Thirty preeclampsia patients(preeclampsia group),hospitalized in Department of Obstetrics,Shengiing Hospital of China Medical University from June 2005 to December 2006,were selected as the subject group,and 40 normal pregnant women as control group.The expressions of LOX-1 and apoptosis related genes caspase-3.Bax and bel-2 in different gestational weeks'placenta tissues were examined using immunohistochemistry.RT-PCR and western-blot.Results (1)Immunohistochemical detection in preeclampsia group:at 20 w+1-24 w,24 w+1-28 w,28 w+1-32 w.32w+1-36 w+1-36 w+1-40 w,respectively,the results of LOX-1 were 20.1±1.8,25.6±1.3,32.8±1.6,34.3 ±1.5,39.9±1.2;in the control group they respectively were 11.2±0.6,18.5±1.6,26.1±1.8,28.3 4-1.6,32.3±1.6;the difierence was significant(P<0.05).In preeclampsia group,the results of easpase-3 were 12.3±0.9,16.3±0.9,24.4 4-0.8,28.3±0.5,36.3±1.1.and in the control group they respectively were 8.5±1.0,12.3±1.1,17.4±1.2,20.4±stronger than those in normal pregnant women at different gestational weeks(P<0.05).However,the expression tendency of bcl-2 mRNA and proten was converse to the expression tendency of Bax.Conclusion The expressions of LOX-1,caspase-3,and Bax are upregulated in placentas of preeclampsia patients,while bcl-2 iS downregulated,both of which are associated with the pathogenesis of preeclampsia.

Objective:To explore the effects of problem-solving based telephone and texting interventions for medication adherence of discharged patients with schizophrenia.Method:A total of 178 discharged patients with schizophrenia were randomly assigned to telephone intervention (TI)group (n =63),text-messaging intervention (TMI)group (n =61),and control group (n =54).All patients were routinely treated,and patients in TI and TMI groups were given problem-solving based interventions.Medication adherence and psychotic symptoms were as-sessed by pill counting and the Positive and Negative Symptom Scale (PANSS)at baseline and the first,third, sixth,ninth and twelfth month.Results:Overall,patients with TI had higher medication adherence than those with TMI (P <0.001),and patients with TMI had higher medication adherence than that in control group (P <0.001). PANSS scores in TI and TMI groups were not significantly different (P >0.05),but significantly lower than control group (P <0.01).There was higher rate of re-admission in control group in comparison with TI and TMI groups (9.3% vs.[0% and 1.6%],P <0.05).Conclusion:It suggests that problem-solving based telephone and texting interventions are effective for improving medication adherence in patients with schizophrenia after their discharge from hospital,so as to reducing psychotic symptoms and lowering re-hospitalization risk.In comparison with TMI, TI has a better effect in improving medication adherence.

Objective To investigate the effect of Saussurea involucrata Injection(SII)on counteracting adjuvant-induced arthritis and its immunoregulation function,thus to supply the pharmacological evidences for the clinical treatment of arthritis.Methods Adjuvant arthritis was induced by plantar injection of Freundi' s complete adjuvant.MTT method was used to detect T and B lymphocytes proliferation,and sheep red blood cell immunization was used for hemolysin determination.Results(1)Rats right posterior metatarsus which was injected adjuvant was swollen from the second day to the 22nd day(the primary injury),and left posterior metatarsus not receiving adjuvant injection was swollen from the sixth day to the 20 th day(the secondary lesion).The differences of swelling degree were significant between SII group and NS group.(2)Consecutive intramuscular injection of SII 0.2,0.4,0.8 mL? kg-1? d-1 for 22 days suppressed the primary injury and the secondary lesion of adjuvant arthritis in rats,relieved swelling significantly from the sixth day(P

Summary Cisplatin is an anti-tumor drug which is widely used for the treatment of various solid tumors. Unfortunately, seriousside-effects have affected patients, such as hearing loss. Up to now, there is no clear and effective measure to protect the cisplatin-induced ototoxicity in the clinical use of cisplatin studies indicated that autophagy may be involved in the whole process of cisplatin-induced hearing loss. In this review, the relationship between cisplatin ototoxicity and autophagy was reviewed. It is hoped that this study can provide reference for further study of cisplatin ototoxicity and intervention of autophagy with autophagy activator or inhibitor.

BACKGROUND:Recently, non-fusion technology representing as artificial cervical disc replacement continues to improve. On the basis of reconstruction of disc structure and function of involved segments, cervical spine structure of surgery area segment is significantly close to dynamic and static load stress distribution required by natural physiological systems. It effects are apparent in protecting intervertebral facet joints of degenerated segment and structure and function of the cervical spine of adjacent segments and in maintaining cervical dynamic stability, which presented obvious methodological strengths compared with segmental fusion technology.
OBJECTIVE:To evaluate the clinical outcomes of anterior cervical discectomy and fusion and Bryan artificial cervical disc replacement in the treatment of single-level cervical spondylotic myelopathy or radiculopathy.
METHODS:A total of 43 middle and old age patients with single-level cervical spondylotic myelopathy or radiculopathy, who were treated from March 2010 to March 2012, were enrol ed in this study. They were randomly assigned to anterior cervical discectomy and fusion group (fusion group) and Bryan artificial cervical disc replacement group. Range-of-motion of cervical overal and adjacent intervertebral area near the intervertebral space was observed with radiography. During fol ow-up, postoperative recovery of neurological function was evaluated using Japanese Orthopaedic Association scale, visual analog scale and neck disability index.
RESULTS AND CONCLUSION:None patients experienced complications of neurovascular injury during and after the surgery. Range-of-motion of postoperative overal cervical vertebra and adjacent joint was improved in the Bryan artificial cervical disc replacement group compared with the fusion group. Neurological function was apparently improved after surgery in each group. At 3 months after surgery, scores of Japanese Orthopaedic Association, visual analog scale and neck disability index were significantly improved in the Bryan artificial cervical disc replacement group compared with the fusion group (P<0.05). During final fol ow-up, there were significant differences in visual analog scale scores between the two groups. Japanese Orthopaedic Association scale score and neck disability index score were similar between the two groups. During fol ow-up, no prosthesis sinking, displacement or heterotopic ossification were detected. These data indicated that artificial cervical disc replacement could effectively keep the range of motion of cervical segments and protect disc degeneration of adjacent segment. Mid-term fol ow up obtained similar improvement of neurological function of fusion surgery. The moderate-term and short-term efficacies of non-fusion technology were better than fusion technology in the treatment of single-level cervical spondylopathy.

Objective To investigate the effect of Dihuang Guanshitong Oral Liquids on expression of E-cadherin of esophageal carcinoma rats. Methods: esophageal membranous epithelium were examined for E-Cadherin by Western blotting. Results: E-cadherin showed obvious low expression in the model group, compared with the normal group (P

OBJECTIVE:To investigate the utilization situation and tendency of antihypertensive drugs in our hospital during the period 2004～ 2005.METHODS:The consumption sum,DDDs and the defined daily cost of antihypertensives during 2004～ 2005 were analyzed statistically.RESULTS:The consumption sum of antihypertensive drugs increased year on year,dominating the first 4 places were calcium antagonists,ACEI,angiotensin receptor antagonists and ? adrenoceptor antagonists.Dominating the first 10 places in terms of consumption sum were chiefly newly marketed,expensive but safe and effective varieties.Leading the top 15 places in terms of DDDs were those drugs that proved to be of confirmed efficacy and lower prices.CONCLUSION:The utilization of antihypertensive drugs in our hospital is basically in line with the general utilization condition home and abroad,and it is up to the current medication principle of antihypertensive drugs