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 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 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 analyze the active principle of Melagenine and its effect on melanocytes of guinea epidermis.Methods The content of endothelins and sialic acid of Melagenine were determined by radioimmunoassay and spectrophotometer.The skin of the back of guinea pigs was treated with Melagenine and irradiated with infrared-ray.Then the biopsy specimens were taken from the treated and untreated back skin,sections and supe-rthin sections were prepared for special staining and TEM examination,respectively,the number melanocytes and melanin content index(MCI)were measured.Results The contents of en-dothelins and sialic acid in melagenine were210.5?30.1pg/mL and147.9?12.1?g/mL,respectively;the number of melanocytes,the keratinocytes with melanin granules and the melanin content index were all in-creased significantly in the treated skin.Conclusions There are endothelins,carbohydrates and glycolipids in melagenine,endothelins can promote the proliferation of melanocytes,while carbohydrates and glycolipids can enhance intercellular recognition and adhesion.The result of the study shows that melagenine promotes the proliferation of melanocytes and synthesis of melanin in the skinof guinea pigs.

Objective To compare the effect of silica-extraction method and Silico membrane based method in DNA purification from bones and teeth.Methods DNA samples were purified respectively with the silica-extraction method and MinElute PCR Purification kit from 6 bones and 8 teeth,then tested STR types by GlobalFiler? kits. And evaluated the two methods with the success rate and the peak height. Results Both of the two purification methods can successfully obtain the STR markers of the 14 samples. And there was no statistical difference between the two methods in the average peak height from bones and teeth. Conclusion The Silico membrane based method which have more advantages in operation is an efficient method to purify DNA from bones and teeth, and there is no significant difference compared with the silica-extraction method. But the cost is higher. It can be selectively used in forensic practice.

Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.