Objective To investigate the clinical effect of compound Chinese medicine fumigation granules on surgical treatment of anorectal disease patients and the impact of postoperative complications and wound healing.Methods 78 cases of patients anorectal surgery from June 2013 to February 2016 in our hospital anorectal were admitted,and were randomly divided into observation group and control group,39 cases in each group,using anti-inflammatory and conventional dressing treatment after operation in both two groups,the observation group was treated with compound Chinese medicine fumigation granules,treatment for 10 days continuous.The changes of wound healing and related clinical symptoms were observed and compared between the two groups.Results Third,7,14 days after operation,VAS scores in observation group were lower than the control group,the differences were statistically significant(P<0.05).Tirst days after operation,there was no significant difference in perianal edema,anal bulge,anal dampness and bleeding symptom score between the observation group and the control group; third,7 days after surgery,the perianal edema,anal bulge,anal wet,bleeding symptom score in observation group were lower than the control group,the differences were statistically significant(P<0.05); fifth,14 days after operation,wound patients smoked wash reduction rate in observation group was higher than the control group,the differences were statistically significant(P<0.05); observation group average wound healing time was(16.3±2.8)days,the control group was(18.4±3.3)days,the differences were statistically significant(P<0.05).Conclusion After surgical treatment of anorectal disease,use the compound Chinese medicine fumigation particles for treatment can help relieve the clinical symptoms of patients,reduce pain,promote wound healing.

[Objective]To investigate the characteristics,treatment and prognosis of tibial plateau fracture of Schatzker type Ⅴ and Ⅵ and recommend the option of the surgical treatment.[Method]From May 2002 to March 2006,arthroscopically assisted double-plating fixation,locking plate with cannulated screws and external fixation with limited internal fixation were performed in 35 patients with tibial plateau fracture of Schatzker Ⅴ and Ⅵ.[Result]All patients were followed up from 12 to 35 months with an average time of 16.5 months.Bone union was achieved in all cases.According to Rasmussen's functional grading system,the excellent,good,fair and poor cases were 19,10,4 and 2,respectively.[Conclusion]CT 3D reconstruction,evaluation of soft tissues injury,suitable operation timing and approaches,anatomical reduction,bone transplantation,proper fixation and right rehabilitation training are all key factors to improve the therapeutic effects on tibial plateau fracture of Schatzker Ⅴ and Ⅵ.

[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 establish a method for the contents determination of harpagoside and stilbene glycoside in Shuang-shen xiaolong granule. METHODS:HPLC of harpagoside was performed on the column of Kromasil 100-5 C18 with mobile phase of acetonitrile-1% acetic acid solution (gradient elution) at flow rate of 1.0 ml/min,detection wavelength was 278 nm,column temperature was 25 ℃ and volume injection was 20 μl. HPLC of stilbene glycoside was performed on the column of Kromasil 100-5 C18 with mobile phase of acetonitrile-water(19∶81,V/V)at flow rate of 1.0 ml/min,etection wavelength was 320 nm,column temperature was 25 ℃ and volume injection was 10 μl. RESULTS:The linear range was 0.555 8-8.893 4 μg for harpagoside(r=0.999 9)and 0.010 6-0.340 2 mg for stilbene glycoside(r=0.999 6);RSDs of precision,stability and reproducibility tests were no more than 1.80%;recoveries were 97.30%-101.35%(RSD=1.43%,n=6) and 96.67%-100.83%(RSD=1.48%,n=6),respec-tively. CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for the contents determination of harpa-goside and stilbene glycoside in Shuangshen xiaolong granule.

OBJECTIVE:To extract and identify the volatile components of the roots of Polyalthia nemoralis,and to evaluate its biological activity in vitro. METHODS:Supercritical CO2 extraction (SFE-CO2) was performed to extract volatile compounds from the roots of P. nemoralis,and the volatile components were separated and determined by GC-MS. Human hepatic cancer Huh-7 cells were cultured with 0(blank control),5,10,20,30,40 and 50 μg(medicinal material)/ml extract for 24 h,and then MTT assay was used to detect the inhibitory effect of the extracts on cells. Relative cell viability and IC50 were calculated. The an-ti-bacterial activities of extract to Staphylococcus aureus,Methicillin-resistant Staphylococcus aureus,Enterococcus faecalis and oth-er strain were determined by Kirby-bauer method and broth dilution method. RESULTS:Forty compounds were identified from the SFE-CO2 extracts from the roots of P. nemoralis. The main constituents were(Z,Z,Z)-9,12,15-octa-decatrien-1-ol,glycerin,cinna-maldehyde,n-hexadecanoic acid and eugenol. Compared with blank control group,SFE-CO2 extracts from the roots of P. nemoralis 5 μg(medicinal material)/ml and above showed significant inhibitory effect on cell growth(P<0.05),and the inhibitory effect was strengthened as the concentration of extracts increased,IC50 values was 5.2 μg(medicinal material)/ml. However,the supercritical extract didn't showed antibacterial activity against three microorganisms in 2 kinds of antibacterial tests. CONCLUSIONS:SFE-CO2 and GC-MS method can effectively extract and identify volatile components of the roots of P. nemoralis,and supercritical extracts can inhibit the viability of cells but have no antibacterial activity.

Objective To explore the expression of DC?SIGN, the phenotype of dendritic cells (DCs), on podocytes, and its role in immune and inflammatory responses of lupus nephritis (LN). Methods DC?SIGN and IgG1 expression in renal tissues of lupus nephritis patients were observed by immunohistochemistry and immunofluorescence. The 4?week old LN mice were randomly divided into the experimental group and the intervention group. C57BL/6J mice were used as normal control group. Mice of the intervention group were injected anti?DC?SIGN antibody at 6?week old. Mice were sacrificed at 16, 20, 24, 28?week old respectively, to observe the mice renal function and pathological changes. And DC?SIGN and IgG1 expression in renal tissue were observed by immunohistochemistry and immunofluorescence. In addition, mice podocytes were treated with serum of LN mice. Flow cytometry was used to investigate the expression of MHC II, CD80 and DC?SIGN expression on podocytes. Mixed lymphocyte reaction was used to detect the ability of stimulating T cells proliferation. IFN?gamma and IL?4 in supernatant were determined by ELISA. Results (1) Expression of DC?SIGN and IgG1 was found in glomeruli of lupus nephritis patients. (2) Accompanied by increased proteinuria of LN mice from 20?week old (P<0.01), DC?SIGN and IgG1 expression was found in glomeruli, and the renal function deteriorated up to 24 week?old (P<0.01). Mice with anti?DC?SIGN antibody intervention appeared reduced proteinuria and remission of renal function (P<0.01). (3) After stimulated by serum of LN mice, the expression of DC?SIGN, MHC II and CD80 was up?regulated, stimulation of T cell proliferation was enhanced (P<0.01), and IFN?gamma/IL?4 ratio increased (P<0.01). Anti?DC?SIGN antibody treatment down?regulated the expressions of DC?SIGN, MHC II and CD80 on podocytes, decreased the ability of stimulating T cell proliferation and lowered the ratio of IFN?gamma/IL?4 (P<0.01). Conclusions Podocytes in lupus nephritis can play DC?like function through the expression of DC?SIGN, which may be involved in immune and inflammatory responses of renal tissue. However, inhibiton of DC?SIGN can depress immune function of podocytes and have prevention and treatment effect.

Objective To use clustering analysis to help physicians detect abnormal parameters in radiotherapy treatment plans and improve the efficiency of plan verification. Methods From 2010 to 2015, 835 breast cancer treatment plans for using 4?field hybrid intensity?modulated radiotherapy from MOSAIQ were collectted. Fractional dose, beam angle, and monitor unit were used as featured parameters of a treatment plan to generate a dataset. The K?means clustering algorithm based on principal component analysis was used to perform a clustering analysis of the dataset and divide the dataset into different clusters. The outliers of clusters were automatically detected based on the distance threshold. The outlier?contained treatment plans were manually verified by physicians to determine the accuracy of clustering analysis in detection of abnormal plans. Results In the clustering analysis, the sample space composed by parameters of treatment plans for breast cancer was divided into 4 clusters, 3 of which had outliers detected. In the targeted treatment plans, 3 plans became outliers because of special target volume and the other 4 plans needed improvement. Conclusions Clustering analysis is effective to help physicians to independently verify treatment plans.

BACKGROUND:As the epiphyseal plate has an important role in the growth and development of femur, the design of internal fixation should avoid the damage to the epiphyseal plate. Therefore, the positioning of pediatric femoral epiphyseal plate is particularly important.
OBJECTIVE:To investigate the biomechanical property of the new femur neck screw internal fixation in treatment of children femoral neck fracture.
METHODS:Twelve femurs were col ected from six fresh children cadavers provided by Dissecting Room of University of South China. After exclusion of bone disease with X-ray film, three new children femoral neck screws and three Kirschner wires with the diameter of 2.0 mm were used for fixation. The biomechanical tests were conducted to detect the axial compression and torsion stiffness.
RESULTS AND CONCLUSION:In the children femoral neck screw group, the axial compression stiffness and torsion stiffness under the torsional torque of maximum 3 N?m were (190.74±20.88) N/mm and (0.18±0.045) N?m/° respectively;(138.95±15.19) N/mm and (0.120±0.036) N?m/° respectively in the Kirschner wire group;there were significant differences in the axial compression stiffness and torsion stiffness between two groups (P<0.05). The results showed that the compressive strength and torsional capacity of the children femoral neck screw were strong than those of Kirschner wire. The experiment suggested that the femoral neck screw for children is a new type of ideal internal fixation device which consist with the anatomical features of children proximal femur and can meet the requirement of children femoral neck fracture with good biomechanical property.

Objective To observe the mitochondrial damage associated with protein-energy wasting of skeletal muscle in diabetic kidney disease (DKD) model of Goto-Kakizaki(GK) rats and evaluate the effects of low-protein diet supplemented with α-keto acids on muscle wasting.Methods Forty-five male 24-week-age GK rats were randomly divided into three groups,normal protein diet group (NPD),low-protein diet group (LPD) and LPD +or-keto group (Keto).Fifteen gender and age matched Wistar rats were served as control group (CTL).The living condition of GK rats was observed and the weight was measured once a week.Urine albumin,serum glucose,creatinine and urea nitrogen were measured at 24,32,40,48 week age.Soleus muscle was observed to calculate the muscle size and the percentage of Ⅰ and Ⅱ type muscle fiber with software after SDH and NADH staining at 48-week-age.Tissue ultrastructure was observed under the transmission electron microscopy.The activity of citrate synthase was detected by spectrophotometer.Expression of mitochondrial DNA was examined by Q-PCR.Results Compared with the CTL group,NPD,LPD and Keto groups had lower body weight,higher urine albumin,higher serum creatinine and urea nitrogen (P ＜ 0.05).The crosssectional area of muscle fibers was larger in CTL group.Compared with CTL group,the muscle fiber was partly broken,the mitochondrial morphology was obviously changed,the percentage of type Ⅱmuscle fiber was increased significantly (P ＜ 0.05),and the activity of citrate synthase and the number of mitochondrial DNA were decreased significantly in NPD,LPD and Keto groups (P ＜ 0.05).In Keto group,muscle wasting was improved compared with NPD and LPD group (P ＜ 0.05),the crosssectional area of soleus muscle increased and the percentage of type Ⅱ muscle fiber decreased,levels of urine albumin,semm creatinine and urea nitrogen decreased (P ＜ 0.05).Under transmission electron microscopy,the muscle fiber of keto group was intact and mitochondiral morphology was close to that of CTL group.The activity of citrate synthase and number of mitochondiral DNA were higher as compared to CTL group (P ＜ 0.05).There were no significant differences between NPD and LPD group.Conclusions In DKD condition,protein degradation in the skeletal muscle is accelerated,mitochondrion is swelling,the number of mitochondrial DNA is decreased and mitochondrial function is impaired.Low-protein diet supplemented with α-keto acids can improve mitochondrial damage and muscle wasting induced by DKD.

Objective To compare the recent clinical efficacy between ileal neobladder and orthotopic ileal neobladder.Methods The clinical data of 62 patients with bladder cancer who were performed with cystectomy plus urinary diversion were retrospectively analyzed.Among them,32 patients were performed with orthotopic ileal neobladder(orthotopic ileal neobladder group)and 30 patients were performed with ileal neobladder(ileal neobladder group).The operation time,intraoperative bleeding,intestinal function recovery time,hospital stay,early postoperative complications were compared between two groups.Results All the patients were successful,and there was no operative deaths occurred.There was no significant difference in the postoperative intestinal function recovery time between two groups(P ＞ 0.05).The operation time,intraoperative bleeding,hospital stay in orthotopic ileal neobladder group was higher than that in ileal neobladder group [(463.59 ± 50.24)min vs.(436.07 ± 44.91)min,(1081.16 ± 320.49)ml vs.(867.53 ± 224.61)ml,(46.88 ± 4.67)d vs.(20.37 ± 5.24)d],but the incidence of early postoperative complications in orthotopic ileal neobladder group was lower than that in ileal neobladder group [25.0％(8/32)vs.53.3％(16/30)],and there were significant differences between two groups(P ＜0.05).Conclusions Two kinds of urinary diversion surgical urinary diversion are clinically more mature manner,in clinical practice.Clinicians should be based on the patient's comprehensive situation,combined with the clinical experience to select the most appropriate surgical procedures.