The hospital culture conveying is a necessary component of hospital culture construction and is a very important work. The spreading out of hospital culture must be persisted, and be sure to embody the hospital culture features, furthermore, the exact carriers should be chosen according to different hospital situation.

[Objective]To analyze the results of distal tibial pilon fractures treated with individual management based on severity of soft tissue injury.[Method]From January 2005 to September 2008,29 Pilon fractures were treated.There were 22 males and 7 females aging from 23 to 63,with an average of 41.4.According to Ruedi-Allgower classification system of Pilon fracture,16 cases were type Ⅱ,13 type Ⅲ.According to Tscherne-Gotzen graduation system of soft tissue injury,22 cases were close fracture,8 grade 0,4 grade 1,8 grade 2,2 grade 3,and 7 cases were open fracture,3 grade 1,2 grade 2,2 grade 3.Individual management was based on severity of soft tissue injury.[Result]All patients were available for follow-up at an average of 28.6 months(range,12 to 56 months) after surgery.There were 10 excellent,13 good,4 fair,and 2 poor results according to the ankle score of Mazur.The complications occurred in 5 patients(17.2%),including wound superficial infection(n=2),skin necrosis(n=1),deep infection(n=1),and pin tract infection(n=1) with external fixation.[Conclusion]Individual management based on severity of soft tissue injury for Pilon fracture has advantages of fewer complications and good function.

Objective To summarize the cause and the level change of laboratory indicators in children with hemphagocytic lym‐phohistiocytosis(HLH) .Methods Retrospectively analyze the cause and the diagnose features of the 13 HLH patients .Results The first symptom of the desease was hyperpyrexia as well as the hepatosplenomegaly and the lymphadenectasis .Then it went with the peripheral cytopenia in two or three lineages ,different degrees of the liver dysfunction and the coagulation abnormalities .The number of histiocytes increased and hemophagocytic macrophages were found in bone marrow .It also showed that the elevated ser‐um triglycerides ,serum ferritin ,lactate dehydrogenase and glutamic‐pyruvic transaminase and decreased fibrinogen in laboratory findings .Conclusion Cytopenia(in two or three lineages ,especially the platelet) ,the elevated serum triglycerides ,serum ferritin , lactate dehydrogenase ,glutamic‐pyruvic transaminase ,decreased fibrinogen and the hemophagocytic macrophages in bone marrow (≥1% ) are important indicators in hemphagocytic lymphohistiocytosis diagnosis ,which could help us know the change of the HLH laboratory features better and diagnose the disease correctly .

Objective To investigate the effects of different doses of rosuvastatin on expression of liver X receptor(LXR) and caveolin-1 in cultured human monocyte-macrophage cells which induced by oxidized low density lipoprotein (ox-LDL).Methods The human monocyte-macrophage cells were divided into six groups:control group,ox-LDL group,different doses of rosuvastatin group (0.01 μmol/L,0.1 μmol/L,1 μmol/L,5 μmol/L).The expression of LXR mRNA and caveolin-1 mRNA were assayed by RT-PCR.Results LXR mRNA expression induced by ox-LDL in the control group and ox-LDL group were 1.00 ± 0.02,0.26 ± 0.02,and the difference was significant (t =56.39,P ＜ 0.001).Meanwhile,caveolin-1 mRNA expression in ox-LDL is (0.27 ± 0.01) fold than that in control (t =31.27,P ＜ 0.001).Meanwhile,There were significant differences among ox-LDL group and the different doses of rosuvastatin group in terms of LXR mRNA and caveolin-1 mRNA expressions (F =72.154,66.007,P ＜ 0.001).Along with the increase the doses of rosuvastatin,there was an increased trends of LXR mRNA and caveolin-1 mRNA expressions (P ＜ 0.05).Conclusion Rosuvastatin and upregulated the LXR mRNA and caveolin-1 mRNA expressions in a dose dependent manner.

Objective The objective of this study was to explore the difference factors for PHC patients by transcatheter arterial chemoembolization of different age groups of senior people in China and support reference for individualized intervention by clinical medical workers.Methods 153 cases of PHC patients by TACE were selected by convenience sampling method from October 2013 to June 2014.The data were collected using general data questionnaire,Health Promotion Strategy Scale,QOL-LC,Memorial Symptom Assessment Scales and Social Support Scale to evaluate the physical,psychological and social aspects of the PHC patients.We divided the patients into young,middle-aged and elderly groups.Single factor and multiple factors regression analysis were used to compare the status and influencing factors.Results Psychological function,value of blood AFP,marital status entered the model and were self-care efficacy and correlated factors of young-aged patients,which could explain 50.6％ of the total varience.Physical symptoms,exploitation degree of support and intervention treatment times entered the model and were self-care efficacy and correlated factors of middle-aged patients,which could explain 47.8％ of the total varience.Symptom distress,degree of cuhural and psychological function entered the model and were self-care efficacy and correlated factors of elderly-aged patients,which could explain 42.4％ of the total varience.Conclusions The self-care efficacy were low in all ages of PHC patients by TACE,it is associated with a variety of factors.Doctors and nurses should pay more attention to the self-care efficacy for PHC patients by transcatheter arterial chemoembolization with different age groups.Also we should evaluate and make well-targeted policies and personalized inter-ventions to promote self-management self-efficacy.

Objective To investigate the effects of leptin on Th17 cells and the possible mechanism. Methods The leptin-deficient ( ob/ob) mice and their homologous wild-type mice were used in the study.The percentages of Th17 cells in peripheral blood samples, spleen tissues and lymph nodes were measured by flow cytometry ( FCM) analysis.The splenic CD4+T cells, separated from the ob/ob mice and the wild-type mice by using magnetic beads,were respectively cultured with leptin at various concentrations and with anti-leptin neu-tralization antibody to evaluate the effects of leptin on Th17 cells.The quantitative real-time PCR was performed to analyze Th17 cell-related cytokines at transcriptional levels.The levels of IL-6 and IL-17A in the supernatants of CD4+T cell culture were measured with Luminex technology.Results Compared with the wild-type mice, the ob/ob mice showed lower percentages of Th17 cells in both peripheral blood samples and spleen tissues (0.49%±0.03%vs 1.29%±0.1%, 1.56%±0.22%vs 2.47%±0.11%).There was a decrease in the percentages of Th17 cells upon the in vitro treatment of CD4+T cells from wild-type mice with anti-leptin antibody.The per-centages of Th17 cells were increased in a dose-dependent manner upon the in vitro treatment of CD4+T cells from ob/ob mice with leptin.Moreover, the levels of IL-17A and IL-6 and the transcriptional levels of RORγt, IL-17A and IL-6 in leptin deficiency group were lower than those of wild-type group, but were increased upon the treatment with leptin.No significant difference with the transcriptional levels of TGF-βand IL-23 was ob-served between the two groups with and without intervention.Conclusion Leptin deficiency seriously hampered the generation of Th17 cells in mice and resulted in a decreased expression of RORγt, IL-17A and IL-6 at mRNA level.The treatment of CD4 T cells with leptin might promote the generation of Th17 cells through up-regulating the transcription of RORγt and IL-6.

Objective To study the expression of PI3K and Akt mRNA in acute leukemia(AL) and chronic myelocytic leukemia (CML) and try to find out a relationship between the prognostic significance of acute leukemia and the expression level of PI3K and Akt. Methods The samples were collected from 63 ALpatients, 7 relapsed AL patients, 14 CML patients and 10 AL patients in complete remission(CR) patients, 11samples of normal controls(NC). The expression of PI3K, Akt mRNA were measured by semi-quantity reverse transcription polymerase chain reaction(RT-PCR). Results The expression of PI3K mRNA in AL and relapse group were significantly higher than that in normal control. In CML, the P13K mRNA expression level was higher than that in NC and CR. The similar results of the expression of Akt mRNA were observed in CML, NC and CR. At the same time, the expression level of Akt mRNA in relapse group was significantly higher than that in NC. The complete remission rate in PI3K (+) was lower than that in PI3K (-). Similar result was obtained in Akt (+) and Akt (-). Conclusion The PI3K/Akt pathway may contribute to the occurrence of leukemia. The patients with positive expression of the members of this pathway had a lower remission rate.

Objective To investigate the effects of VEGF-induced expression of Survivin by colon cancer cells (LOVO, HCT116) and human umbilical vein endothelial cells (HUVECs). Methods VEGF was used to stimu-late the LOVO, HCT116, HUVECs. We used RT-PCR and Western blot to estimate the expression of Survivin in different cells, and immunocytochemistry to investigate the expression level and site of Survivin protein. Results Survivin was expressed highly in the cytoplasm and was upregulated with the induction of VEGF. In HUVECs, Sur-vivin expression was not obvious but significantly upregulated with the inductioin of VEGF in the cytoplasm and nu-cleus. Conclusion The expression of Survivin mRNA and protein are upregulated by VEGF stimulation. The level and distribution of Survivin are different in tumor cell lines and non-tumorgenicity cells.

Objective:To analyze normal pure tone hearing thresholds patients with aural fullness using evoked otoacoustic emission in order to detect the early cochlear impairment. Method: Forty-three normal pure tone hearing thresholds patients(72 ears,aural fullness group)with aural fullness were served as subjects and 30 normal volunteers(60 ears,control group)as controls. Transiently evoked otoacoustic emission (TEOAE) and distortion product evoked otoacoustic emission (DPOAE) were tested with Capella otoacoustic emission machine.The DPOAE detection rate and amplitudes at all frequencies,the passing rate and wave signal noise ratio (SNR), wave reproducibility,band SNR and band reproducibility of TEOAE were recorded and analyzed.Result:①Only on the frequency points of 0. 50 kHz and 0. 75 kHz,the detection rate of DPOAE in aural fullness group was lower than that in control group(P＜0. 05). There was no significant difference in the rate among other frequency points(P＞0. 05). ②The passing rate of TEOAE was 100% in control group and 90.28% in aural fullness group.There were statistical differences between two groups(X~2=6. 16, P＜0. 05).③Compared with the control group,the DPOAE amplitudes at all frequencies,the wave signal noise ratio(SNR), wave reproducibility,band SNR and band reproducibility of TEOAE in patients with aural fullness were significantly decreased.There were statistical differences(P＜0.05 or P＜0.01). Conclusion:Some patients of normal hearing thresholds with aural fullness have had early harm of outer hair cell in cochlear.TEOAE and DPOAE may be used to detect these lesions early before the hearing impairment occurred.

Objective To investigate the serum levels of soluble CD23 ( sCD23 ) and thrombopeietin (TPO) in chronic lymphocytic leukemia (CLL) and their correlation with other prognostic factors. Methods The serum levels of sCD23 and TPO of 25 CLL patients were detected with enzyme linked immunosorbent assay. Flow cytometry was employed to determine the expression of CD38 and ZAP-70 protein. Results TPO level in CLL patients was significantly higher than that in normal controls 67.22 - 1881.77 ng/L and 70. 29 - 147. 98 ng/L respectively, P =0. 003. sCD23 level in CLL patients was significantly higher than that in normal controls 129. 80-405. 31 U/ml and 0. 65 -32. 99 U/ml respectively, P =0. 000. TPO level was significantly correlated with Binet stage and CD38 expression. Patients in stage B and C had higher level of TPO than those in stage A 140. 57 -457.48 ng/L and 121.92 - 163.83 ng/L respectively, P =0.014,while TPO level was higher in patients with higher CD38 expression than in patients lower CD38 expression 113.23- 199. 10 ng/L and 141.34 -454. 92 ng/L respectively, P = 0. 033. No significant correlation of sCD23 and TPO levels with ZAP-70 protein, sex, age, peripheral lymphocyte count and lactate dehydrogenase were observed. Conclusion Serum TPO level might be a prognostic factor in CLL.