BACKGROUND:With the development of minimal y invasive technique, more and more forearm fracture, especial y in children, was treated by elastic stable intramedul ary nailing. Recently, elastic stable intramedul ary nailing was also used in elder children, even adults. In particular, this technique has obtained good curative effects for open fracture and unstable fracture. OBJECTIVE:To evaluate the clinical effectiveness and safety of elastic intramedul ary nail and plate fixation for double fracture of forearm using evidence-based medicine. METHODS:We retrieved PubMed, Embase, Cochrane Library, China Biology Medicine, VIP, China National Knowledge Infrastructure, WanFang, and other electronic databases. The quality of the included studies was assessed using Cochrane Systematic Review. The analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:A total of 7 randomized control ed trials involving 468 cases were included. The results of meta-analyses showed that compared with plate fixation group, effective rate was higher in the titanium elastic nail group (P<0.000 1), the time of fracture healing was shorter (P<0.000 01), and the hospitalization time was shorter (P<0.000 01). In the aspect of adverse reactions, incidence of refracture (P=0.03) and breakage of internal fixation (P=0.03) was significantly lower. These indicated that compared with plate fixation, titanium elastic nail can improve the total effective rate, shorten the time of fracture healing on X-ray and the hospitalization time, at the same time, can effectively reduce the complications of refracture and breakage of internal fixation.

Objective To compare the contents of berberine,palmatine,jatrorrhizine,baicalin and geniposide between traditional decoction and dispensing granule decoction of Huanglian Jiedu Decoction.Methods A HPLC method was carried out on Diamonsil C18 column(250 ? 4.6 mm,5 ?m).The mixture of H2O(A),CH3OH(B)and 0.05 % H3PO4 solution(C)was used as the mobile phase for gradient elution.The column temperature was set up at 35 ℃ and the flow rate was l mL/min.The detection wavelength was 345nm for berberine,palmtine and jatrorrhizine,280 nm for baicalin,and 238 nm for geniposide.Results This method can be used to determine 5 components in Huanglian Jiedu Decoction at the same time and the method was rapid,sensitive and accurate.Conclusion The HPLC chromatograms of traditional sliced decoction of Huanglian Jiedu Decoction are similar to the dispensing granule decoction.The contents of 5 main components in dispensing granule decoction are higher than those in traditional sliced decoction.

Objective To illustrate and discuss the technique and clinical value of scapula Y-position radiography.Methods Scapula Y-position radiographies were performed on 110 patients with shoulder joint injury or omalgia.The patient standed in front of the panel face to face, with the affected joint closed to the panel, and the arms fell naturally and palms pronated to stick close to the body.The angle between the coronal plane and the panel was about 55 to 65 degree, put the affected caput humeri at the center of the panel,tilted the tube to foot-side by 15 degree,and aimed the axis at caput humeri.Results Among the 110 patients, 82 radiographies were successfully taken by the first time,28 failed because of the inappropriate body-tilt angle.We had exposed 5 acromion fractures cases, 20 flexural and hook-form acromion cases, 35 cases with the acomion-caput humeri distance less than 1 cm, and 2 coracoid fracture cases.Conclusion Scapula Y-position radiography has high clinical value that could expose the osseous anatomic exit of the rotator cuff and guide the clinical treatments.

OBJECTIVE:To establish a HPLC method for determining the contents of rhein and emodin in Jianfei Jiangzhi tablets.METHODS:Stationary phase was Waters Symmetry C 18 (250mm?4.6mm;5?m),mobile phase was menthol-0.01%H 3 PO 4 (90∶10),detection wavelength440nm,flow rate1.0ml/min and column temperature30℃.RESULTS:There was good linearity in range of0.108?g～0.468?g for rhein and in range of0.180?g～0.480?g for emodin.The average recoveries of rhein and emodin were99.7%and98.6%respectively;RSD were1.93%and2.19%respectively.CONCLUSION:This method is rapid and accurate.It can be applied to effective control of the quality of Jianfei Jiangzhi tablet.

Objective To review the publication of general practice education in China mainland in 20 years from 1993 to 2012.Methods The research articles of general practice education published between January 1,1993 and December 31,2012 were searched from CNKI and Wanfang databases, and analyzed with bibliometric and literature management software NoteExpress 2, Epidata 3.1 and SPSS 13.0.Results Total 4 281 articles were retrieved and 241 education relevant articles were selected.29.9％ (72/241) of the 241 articles were on on-campus education, 67.6％ (163/241) were on continuing medical education and 4.5％ (11/241) were on post-graduation education.As to the published institutions, 58.5％ (141/241) were from the medical colleges and research institutions, 25.7％ (62/241 were from the tertiary hospitals, 3.7％ (9/241) were from primary care institutions, 1.7％ (4/241 were from the secondary hospitals and 5.8％ (14/241) were from the government departments.The general practice education grants increased from 1 in 2001 to 46 in 2012;20 of which were supported by provincial and ministerial level funds.Conclusion The contents of general medical education literature in China is mainly on on-campus education and continuing medical education;most of which were from the tertiary hospitals and the medical colleges and research institutions.The amount of research grants of general practice education were increasing year by year during 1993-2012, indicating that more attention had been paid to general practice education in mainland China in the last two decades.

Objective: To determine the anti rejection effects of CTLA 4 Ig fusion protein on cardiac allografts in mice and to discuss its mechanism in vivo . Methods: BALB/c recipients were performed cervical heterotopic heart transplantation to receive C57BL/6 donor hearts with a cuff technique. BALB/c recipients were intraperitoneally injected with CTLA 4 Ig [100 ?g/d?15 times], control immunoglobins and PBS to observe the survival time of allografts with ECG. The hyporesponsiveness of splenic T cell, the polarization of the T subsets were analyzed after the recipients treated with CTLA 4 Ig. Results: After treated with CTLA 4 Ig, the survival of cardiac grafts was significantly prolonged compared with the control groups, and more than 40% cardiac grafts survived over 2 months. The splenic T cells isolated from recipients did not respond to restimulation of donor splenocytes in MLR, but did exhibit the capacity to proliferate in response to C3H splenocytes(third party).The levels of IL 2 and IFN ? decreased and the level of IL 10 increased in CTLA 4 Ig treated mice. Conclusion: Administration of CTLA 4 Ig can induce donor specific tolerance, which induce T subsets to polarize toward Th2 subset and hyporesponsiveness to alloantigen, and prolong the survival time of the cardiac grafts effectively. [

Objective To investigate the preventive and therapeutic effects of vesiculation moxibustion on rat hepatic fibrosis (HF).Methods Thirty rats were randomly allocated to treatment, model and control groups, 10 rats each. A rat model of HF was made by intraperitoneal injection of carbon tetrachloride. At three weeks after model making, the treatment group was treated by vesiculation moxibustion 6 hrs twice a week, for a total of 4 weeks. Body weight, liver wet weight, liver index, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) contents, and serum and liver typeⅢ procollagen (PCⅢ), typeⅣ collagen (Ⅳ-C), hyaluronic acid (HA) and laminin (LN) contents were measured in every group of rats.Results There were statistically significant differences in HF severity grade and HF tissue collagen analysis indices between the model group of rats and the treatment group or the control group (P<0.01,P<0.05). There were statistically significant differences in body weight, liver wet weight and liver index between the model and control groups of rats (P<0.01). There were statistically significant differences in liver wet weight and liver index between the treatment and model groups of rats (P<0.01). There were statistically significant differences in serum ALT and AST contents, and serum and liver PCⅢ,Ⅳ-C, HA and LN contents between the model and control groups of rats (P<0.01,P<0.05). There were statistically significant differences in serum ALT and AST contents, and serum and liverⅣ-C, HA and LN contents between the treatment and model groups of rats (P<0.01,P<0.05). There was a statistically significant difference in serum PCⅢ content between the treatment and model groups of rats (P<0.01).Conclusion Vesiculation moxibustion has some preventive and therapeutic effects on rat hepatic fibrosis.

OBJECTIVE:To develop a HPLC method for determination of tinidazole and chlorhexidine acetate in co-tinidazole gargle.METHODS:Tinidazole and chlorhexidine acetate in co-tinidazole gargle were determined by RP-HPLC with metronidazole as the internal standard.ODS was adopted as stationary phase and acetonitrile-water(35∶65)as mobile phase.The detector was operated at UV254nm.RESULTS:The calibration curve of tinidazole was linear within the concen?tration range of(0.01～0.10)mg/ml(r=0.9999);The calibration curve of chlorhexidine acetate was linear within the con?centration range of(0.01～0.10)mg/ml(r=0.9997).The average recoveries of tinidazole and chlorhexidine were(97.06～102.02)%and(97.21～103.40)%,respectively.The within-day coefficients of variance were(0.20～1.26)%and(0.71～1.11)%,respectively.The between-days coefficients of variance were(0.50～2.06)%and(0.80～2.17)%,respective?ly.CONCLUSION:The method is suitable for determination of preparations containing tinidazole and chlorhexidine acetate.

Objective:To investigate the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT metabolic parameters for occult lymph node metastasis (OLM) in non-small cell lung cancer (NSCLC). Methods:A total of 183 patients (72 males, 111 females; age (61.5±8.4) years) who underwent 18F-FDG PET/CT and preoperatively diagnosed with clinical N0 stage (cN0) in Third Affiliated Hospital of Soochow University from January 2013 to December 2018 were retrospectively enrolled. All patients underwent anatomical pulmonary resection with systematic lymph node dissections within 3 weeks after 18F-FDG PET/CT examinations. According to the presence or absence of lymph node metastasis, patients were divided into OLM positive (OLM+ ) group and OLM negative (OLM-) group. Parameters of primary lesions, such as the maximum diameter (D max), tumor sites, morphological features, maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), metabolic total volume (MTV), total lesion glycolysis (TLG), tumor SUV max to liver SUV mean (TLR max), tumor TLG to liver SUV mean (TLR TLG) were analyzed. Mann-Whitney U test and χ2 test were used to compare the parameters between groups. Multivariable logistic regression was used to analyze the independent risk factors for OLM. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different parameters. Results:Among 183 patients, 25 (13.7%, 25/183) of them were diagnosed as OLM. In OLM+ group, 46 lymph nodes were pathologically positive for metastasis, including 15 N1 disease and 31 N2 disease. D max (2.9(2.3, 3.7) vs 2.3(1.7, 2.8) cm), lobulation ((76.0%(19/25) vs 37.3%(59/158)), SUV max (11.1(7.9, 17.7) vs 4.7(2.3, 9.2)), TLG (41.5(10.2, 91.1) vs 15.6(6.5, 23.8) ml), TLR max (4.7(3.5, 7.6) vs 2.1(0.9, 4.0)) and TLR TLG (18.1(5.0, 44.3) vs 6.1(3.0, 11.4) ml) of the primary lesions in OLM+ group were significantly higher than those in OLM-group ( z values: from -4.709 to -3.247, χ2=13.190, all P<0.05). Multivariable logistic regression analysis showed that TLR max (odds ratio ( OR)=15.145, 95% CI: 3.381-67.830, P<0.001) and D max ( OR=3.220, 95% CI: 1.192-8.701, P=0.021) were independent risk factors for OLM. TLR max yielded the highest area under curve (AUC; AUC=0.794) with the threshold of 3.12, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value for predicting OLM were 92.0%(23/25), 63.3%(100/158), 67.2%(123/183), 28.4%(23/81) and 98.0%(100/102), respectively. Conclusions:TLR max of tumor is the independent risk factor for OLM in NSCLC patients. TLR max can sensitively predict OLM preoperatively in patients with NSCLC.

Objective To study the relationship among the sense of organizational fairness, innovative self-efficacy (ISE) and innovative behavior in nurses. Methods A total of 392 nurses from a grade A tertiary hospital were selected as the research subjects using convenience sampling method. The Organizational Fairness Scale, Innovation Self-efficacy Scale, and Innovation Behavior Scale were used to evaluate the sense of organizational fairness, ISE, and innovation behavior, respectively. The mediate equation model was constructed, and Bootstrap analysis was applied for validation. Results The scores for organizational fairness, ISE, and innovative behavior among the nurses were (67.8±15.2), (23.9±3.5), and (30.5±6.7) points, respectively. Organizational fairness score was positively correlated with both innovative behavior and ISE scores ［correlation coefficients (r) were 0.38 and 0.36, respectively, both P<0.01］. ISE score was positively correlated with innovative behavior total score (r=0.51, P<0.01). The results of the mediation analysis indicated that the total effect of organizational fairness on innovation behavior was 0.34 (P<0.01),with a direct effect of 0.17 (P<0.01). ISE plays a mediating role between organizational fairness and innovation behavior among nurses(P<0.01) with standardized mediation effect of 0.17, accounting for 50.0% of the total effect. Conclusion Organizational fairness can influence the ability of innovative behavior directly or through the mediating role of ISE.