Objective To compare the healing effect of compound tibial and fibular fractures with two different fixation methods of external fixators (EF) and interlocking intramedullary nail ( INF). Methods Eighty-six cases of compound tibial and fibular fractures received different treatment, 36 cases in EF group and 50 cases in INF group. The difference between two groups was statistically analyzed according to WU Yue-song and XU Bo-cheng standard and Johner-Wruh score. Results All cases were followedup for 6-24 months,average (16.0 ± 2.4) months. The excellent and good rate were 80.6% (29/36) in EF group and 88.0%(44/50) in INF group respectively. There was no significant difference between two groups (Z =-1.103,P ＞0.05). Conclusions To the compound tibial and fibular fractures patients,INF can be considered as an effective method. It's an important therapy choice with EF to heal the compound tibial and fibular fractures.

We analyzed the special characteristics of postgraduate education for anesthesiology majors based on the current situation of medical postgraduate education.Next,we introduced the ‘ sandwich' teaching method and discussed how it can promote students' subjective initiative by transforming various learning patterns.Finally,the effectiveness of study was elevated by ‘sandwich' teaching method.

BACKGROUND:The pathogenesis of knee osteoarthritis is stil not very clear, and there is a lack of early diagnosis methods. Because it is more common in middle-aged women, it is suggested that the pathogenesis of knee osteoarthritis may be closely related to serum estradiol levels in the human body. OBJECTIVE:To explore the correlation between the level of serum estradiol and the severity of osteoarthritis in female patients with knee osteoarthritis. METHODS:Seventy-six female patients with knee osteoarthritis admitted in the First Affiliated Hospital of Guangxi Medical University from February 2012 to December 2013 were enroled, and divided into premenopause group (n=42) and postmenopause group (n=34). According to Kelgren-Lawrence (K-L) grading, both two groups were subdivided into K-L 0, II and IV groups. The knee function was evaluated with Hospital for Special Surgery (HSS) Knee Score Standard in USA, the serum estradiol levels were detected with electrochemiluminescence immunoassay. Then, the correlation analysis was performed. RESULTS AND CONCLUSION: The serum estradiol levels of the premenopause group and postmenopause group were decreased significantly with the increase of K-L grade and age (P < 0.05). Under the same K-L grade, the serum estradiol levels in the postmenopausal patients were significantly lower than those in the premenopausal patients. Linear regression analysis showed that there was a negative relationship between age and serum estradiol level (R2=0.222,P < 0.05), and there was a positive correlation between HSS scores and serum estradiol levels (R2=0.415,P < 0.05). The severity of knee osteoarthritis in female patients shows a negative correlation with the level of serum estradiol but a positive correlation with age.

Hepatolithiasis is still a common biliary disease in China with unknown pathogenesis and poor long-term outcomes.Surgery is probably the only curative treatment to hepatolithiasis.However,surgeons and patients cannot keep trouble from high recurrence and reoperation rates after surgery.Hepatolithiasis is a serious disease,which can cause cholangitis,liver abscess,liver cirrhosis,and even cholangiocarcinoma.Sphincter of Oddi,which controls the unidirectional outflow of bile and separates the bile duct from the bacteria-filled intestinal tract,is thought to be a gatekeeper of the almost-sterile biliary tract.Dysfunction of sphincter of Oddi,including stenosis,spasm and laxity,is closely associated with biliary disease,A lax sphincter of Oddi will aggravate bilioenteric reflux,leading to biliary infection and calculi development eventually.This issue has gradually gained enough attention.How to evaluate sphincter of Oddi function reliably and restore or replace its function,which is key to treat hepatolithiasis and prevent its recurrence,remain unclear.

Adenocarcinoma, Clear Cell ; pathology ; Adult ; Female ; Humans ; Thyroid Neoplasms ; pathology

Lives are maintained by enough oxygen.Blood oxygen saturation is one of the important parameters which reflects oxygen concentration in blood.The accurate monitoring of blood oxygen saturation is very important to both physiological research and medical application.At present,dual-wavelength method is widely adopted in noninvasive detection of blood oxygen saturation.Therefore,accurate recognition of peak-to-peak value of pulse waveform is a key process in monitoring blood oxygen saturation.In the paper,LMS self-adaptive arithmetic is applied to processing pulse waveform signal.The ratio of corrective detection is improved by the method.

Objective To investigate the value of DNA-image cyt-ometry (DNA-ICM) in the diagnosis of urothelial cell carcinomas (UCC). Methods Totally 162 voided urine specimens (92 cases from urothel-ial car-cinomas patients and 70 cases from benign urinary system diseases patients ) were detected with DNA-ICM and liquid-based cytology (LBC), respectively. Results The sensitivity and specificity of DNA-ICM were 65.2%and 100% respectively in the diagnosis of UCC but those of LBC were 27.2% and 98.6%, respectively. The sensitivity of DNA-ICM was significantly higher than that of LBC in the diagnosis of UCC (P < 0.01). The sen-sitivity of DNA-ICM in upper urinary tract urothelial cell carcinomas (UTUC) were 77.1%, which was much higher than that in bladder urothelial cell carcinomas (57.9%) but no statistical significance was found (P >0.01). Conclusion DNA-ICM, which improves the positive rate of urinary cytology, has great application value in the diagnosis of urothelial cell carcinomas and it is an effective screening method for urothelial cancer in diag-nosis and follow-up.

Background:Currently,chronic atrophic gastritis( CAG)is diagnosed by endoscopy combined with pathological examination. Narrow-band imaging magnifying endoscopy( NBI-ME)has been widely applied to diagnose CAG. However, it is a issue how to optimize the examination technology. Aims:To investigate the clinical value of NBI-ME in diagnosis of CAG,intestinal metaplasia and intraepithelial neoplasia. Methods:One hundred CAG patients reexamined gastroscopy were enrolled,sequential examination was performd,i. e. the extent of disease was observed under convention white light endoscopy( C-WLI ) followed by NBI-ME mode to observe locally,morphological changes of gastric mucosa pit was analyzed,endoscopic findings and histological results was compared. Results:Sensitivity of sequential examination for the diagnosis of CAG was 89. 7%,specificity was 63. 3%;sensitivity and specificity for the diagnosis of intestinal metaplasia were 89. 4%,89. 3%,respectively,for intraepithelial neoplasia were 84. 2%,95. 9%,respectively. Conclusions:Sequential examination can significantly improve the diagnostic accuracies of CAG,intestinal metaplasia and intraepithelial neoplasia,and effectively guide targeted biopsy,and easily to operate.

The use of flaps for plastic and reconstructive surgery is very popular today.More and more surgeons have realized that the blood supply plays an important role in the design and survival of flaps.After Ian McGregor and Ian Jackson first introduced the axial flaps into clinics,Mathes divided the flaps into two types in 1981,the fasciocutaneous perforator flaps and musculocutaneous perforator flaps.In 1989,the concept of perforator flap was first brought into clinical practice.With the development of microsurgery and anatomy,the epidermis of human skin is divided into areas based on the vascular anatomy.A new century of musculocutaneous perforator flaps has been established.The terminology,classification,characteristics and application of musculocutaneous perforator flaps are described in this paper.

Objective To investigate clinieopathologic characteristics and therapy of local advanced welldifferentiated thyroid carcinoma.Methods Data of 23 cases of advanced well-differentiated thyroid carcinoma treated from Jan.1996 to Dec.2005 were retrospectively reviewed.The data included age,pathologic type,local invasion,operative plan,postoperative complications and survival duration.Results Histology showed there were 15 cases of papillary carcinoma,6 ca8es of follicular carcinoma,and 2 cases of papiIlary follicular carcinoma.8 cases had local invasion into recurrent laryngeal nerve,12 cases had invasion into trachea,3 cases had trachea and esophagus invasion,and 8 cases had suprahyoid muscle invasion.All the 23 cases underwent resection procedure.According to surgical procedure,they were divided into radical resection group(n=6),tumor resection group(n=14)and tumor debulking group(n=3).2 cases received radiotherapy after thyroidectomy in tumor debulking group.All patients were followed up.Overall survival rate after 1 year,3 years and 5 years Was 91.3%(21/23),82.6%(19/23),and 60.8%(14/23)respectively.Prognosis of radical tumor removal group and tumor resection group was obviously better than that of tumor debulking group.Conclusions Prognosis is good for local advanced well-differentiated thyroid carcinoma patients receiving resection.Protection of local organ function Can enhance postoperative life quality.