Objective To evaluate the effect of internal fixation with anatomic plate in treatment of in-tra-articular calcaneal fractures with different hone grafting methods.Methods 40 fractures in 37 patients with intra-articular calcancai fractures were given internal fixation with anatomic plate.Ilium grafting was done in type II and ID (Sanders' classification) cases,and reconstruction of articular surface using iliac crest with periosteum in type VI cases.The foot functions of the patients were evaluated according to Maryland Foot Scoro.Results In the 28 fractures who were followed up for 6 to 48 months,excellent results were obtained in 13(46.4% ),good in 14 (50% ),fair in 1 (3.6% ),with the excellent and good rate being 96.4%.Conclusion Being able to effectively support the articular surface of calcaneus,the anatomic plate is a fine internal fixation device for calcancai fractures,and grafting using iliac crest with periosteum is an effective method to repair defects of the articular surface.

Objective To explore the early surgical treatment for sleep apnea in children with the influence of mental development,provide important basis for children with sleep apnea early surgery.Methods 40 children with sleep apnea underwent bilateral amygdala and/or adenoidectomy (observation group).The Chinese wechsler intelligence scale for children (C-WYCSI) was used for preoperative and postoperative 6 months of intelligence tests,including language IQ and operation IQ test two parts,a total of 11 points.Operation IQ but also contain visual analysis test(VA) and two categories,including geometry test (GD).According to the 1 ∶ 1 matching selection of the same gender,and age(± 3 months),family condition was quite healthy check-up preschool children comparing 40 cases as control group.Results Observation group preoperative total intelligence quotient (IQ),verbal IQ,IQ operation was 82,81,83,respectively,which were lower than those of the control group 101,101,101 (t =4.131,3.952,3.842,all P ＜ 0.05).Postoperative total intelligence quotient(IQ),verbal IQ and operation IQ 98,98,99,respectively,were in normal range,with no statistically significant difference were observed in the control group (all P ＞ 0.05).Conclusion Children with sleep apnea early surgical treatment can improve children mental development.Children with sleep apnea early,breathing and surgical indications should be early surgical treatment.

Objective To analyze the clinical manifestation of thyroid carcinoma in patient with nodular goiter,and explore the effective diagnosis and treatment method.Methods Retrospective analysis was made on patients operated upon for nodular goiter with coexisting diffetentiated thyroid carcinoma.Results Tiny papillary car-cinoma 9 cases,papillary carcinoma 1 1 cases,and follicular carcinoma 1 case.Four Chad cervical lymph node involve-ment,2 cases in the cervical compartment and 2 cases in the central area.We followed up for 10 months to 10 years, all of the patients were survival.Conclusion Early diagnosis can provide scientific basis for surgical treatment.Oper-ation should master the indication and scope,to ensure the satety,impove survival rate.

Objective To evaluate the clinical value of gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.Methods 15 cases received gasless video-assisted endoscopic thyroidectomy by infraclavicular wall.13 cases underwent total thyroidectomy,2 cases underwent subtotal thyroidectomy.All 15 cases were protected recurrent laryngeal nerve and parathyroid by inspecting during the operation.Results All 15 patients were cured without hoarse and tetany,and the flaps without hematomas and extravasated blood.Conclusion Gasless video-assisted endoscopic thyroidectomy by infraclavicular also can reach the principle demand by the tradional opening way.As the supremacy way of aesthetic and hidden,it can be used to the patients who want high request on faces.

Poly(β-amino esters) (PBAE) are used for drug carrier and have many advantages, such as pH-sensitivity, low toxicity, structural diversity and the synthetic method of PBAE is easy. Therefore they are possessed broad application prospect in tumor-targeted drugs delivery systems. In this paper, the structural features and target drugs delivery property of PBAE are reviewed. The application forms of PBAE and different anti-cancer drugs loaded in the copolymer for tumor-targeted drugs delivery systems are introduced particularly.

Objective To investigate in vitro activities of 5 fungal agents(amphotericin B,ketoconazole,fluconasole,5-fluorocytoaine and itroconazole)against Penicillium marneffei,providing references for clinical treatment.Methods E-test was used to test the in vitro susceptibilities of 5 antifungal agents (amphotericin B,ketoconazole,fluconasole,5-fluorocytoaine and itroconazole)against yeast form and mycelial form of 52 Penicillium marneffei strains isolated from our hospital.Results The 90% minimal inhibitory concentrations(MIC90)of amphotericin B,ketoconazole,fluconasole,5-fluorocytoaine and itroconazole against yeast form of Penicillium marneffei were 0.250,0.160,24.000,4.000,0.006 mg/L,the minimal inhibitory concentration(MIC)ranges were 0.004-0.500,0.002-0.016,1.000-256.000,0.002-32.000 and 0.002-0.008 mg/L,respectively;the MIG90 of the 5 agents against mycelial form of Penicil lium marneffei were 1.500,0.125,256.000,24.000 and 0.012 mg/L,respectively;the MIC ranges were 0.064-4.000,0-006-0.940,1-000-256.000,0.125-32.000 and 0.002-0.064 mg/L respectively.Five antifungal agents had different susceptibility patterns against both forms of Penicillium marneffei.And itroconazole was the most susceptible one,ketoconazole follows as the second.There was significant difference between the MICs of the same agent against yeast form of Penicillium marneffei and mycelial form of Penicillium marneffei.Conclusion In vitro antifungal agents suscepbibility tests of Penicillium marneffei can provide important references information for clinical treatment.

Objective To investigate the clinical efficacy of biological amniotic membrane for otoscpic repair of traumatic perforation of tympanic membrane. Methods Otoscpic repair was performed on the patients with tympanic membrane perforation which was not healed for 6 months. The efficacy was observed postoperatively. Results The success rate of the procedure was 97.37%, except that one patient was not healing by first intention due to wound infection. Conclusions Biological amniotic membrane is definitely efficacious in the surgical repair of perforation of tympanic membrane. Otoscpic sugical repair is less invassive and has a higher success rate.

Objective To explore the effect of social medical treatment in improving the quality of life for patients with nasopharyngeal carcinoma.Methods 32 patients with nasopharyngeal carcinoma were mentioned with social medical treatment (including psychological treatment,family visit,family tend,social healing service,etc).The result was measured by using the SQOL-NPC.and the different stages of the results were compared.Results All the patients were tracked in 2 years.All the scores were mark down in a table.Conclusion After analyzing the results,it was found that social medical treatment played an important role in improving the quality of life for patients with nasopharyngeal carcinoma.

Objective To observe the effect of Bacillus coagulans tablets Combined with minus Xiaoyao powder, Nifuratel nystatin soft capsule in treatment of VVC. Methods A total of 108 cases of VVC. patients were randomly divided into 2 groups:observation group and control group. In the observation group (n=54), patients were given vaginal placement of Nifuratel nystatin soft capsule, 1 capsule daily, for 6 days;oral administration of minus Xiaoyao powder, 1 agent daily, for 7 days; and oral administration of Bacillus coagulans tablets, 3 tablets one time, 3 times a day, for 14 days, double dose at first. In control group (54 cases), patients were given vaginal placement of Nifuratel nystatin soft capsule, 1 capsule daily, for 6 days;and oral placement of vitamin C tablet, 1 tablet one time, 3 times a day,for 14 days. The short-term effect and the long-term recurrence of were observed 3-7 days, 1 months, 3 months, 6 months after stopping drug treatment. Results 3 days after stopping drugs, the effective rate in the observation group and the control group was 92.59%and 81.48%, respectively, the difference between the two groups was statistically significant (P<0.05) . 6 months after stopping drugs, the recurrence rate was 9.26% in the observation group, and 20.37% in the control group, the difference was statistically significant (P<0.05) . Conclusion For Vaginal candidiasis, on the basis of antifungal therapy, giving Bacillus coagulans tablets for regulation of intestinal micro ecological environment, and traditional Chinese medicine minus Xiaoyao powder for clearing heat and removing dampness, soothing the liver, can significantly improve the short term and long term curative effects,and reduce the recurrence rate.

Objective:To compare various data of open pyeloplasty,laparoscopic pyeloplasty and en-dopyelotomy as a treatment of ureteropelvic junction obstruction(UPJO),and to investigate and discuss the feasibility and effect of the three methods.Methods:In the study,109 cases of UPJO treated by dif-ferent surgical approaches in Peking University People’s Hospital from January 2004 to December 2014 were retrospectively investigated.The patients were divided into three groups according to the treatment they received:open peyloplasty group (32 cases),laparoscopic peyloplasty group (31 cases)and en-dopyelotomy group (46 cases).We compared the data of the operative time,intraoperative blood loss, perioperative complications and post-operative hospital stay among the three groups.The mean follow-up time was(51.9 ±40.1 )months (6 -132 months).Results:None of the laparoscopic peyloplties was converted to open peyloplasty.All endpyelotomies were successfully completed.The operative time was as follows:laparoscopic peyloplasty group (195.97 ±55.22)min,open peyloplasty group (121.19 ± 33.95)min and endopyelotomy group (74.04 ±33.95 )min,and there were significant differences among the three groups respectively(P <0.001 ).There was no significant difference on the operative blood loss between open peyloplasty group and laparoscopic peyloplasty group (P =0.163).The opera-tive blood loss of endopyelotomy group was 5(0,310)mL,which was lower than the other two groups,and this result had significant differences with the other two groups respectively(P <0.001).There were sig-nificant differences on the post-operative hospital stay (days)among open peyloplasty group,laparoscopic peyloplasty group and endopeylotomy group (P <0.05,respectively).The success rate was comparable between open peyloplasty group and laparoscopic peyloplasty group(93.8% vs.90.3%,P =0.672), while the endopeylotomy group had a lower success rate compared with both open surgery group and laparo-scopic group(69.6% vs.93.8%,P =0.01;69.6% vs.90.3%,P =0.048,respectively).The complica-tion rates of open peyloplasty group,laparoscopic peyloplasty group and endopeylotomy group were compa-rable(15.6%,16.1% and 13.0%,respectively,P >0.05).Conclusion:The laparoscopic peyloplasty group had a longer operative time than open peyloplasty group,while its post-operative stay was shorter. There was no significant difference on the operative blood loss between open peyloplasty group and laparo-scopic peyloplasty group.Although the success rate of endopyelotomy was lower than those of the other two groups,it had advantages over the aspect of operative time,operative blood loss and post operative stay.