Objective To seek an effective method for the treatment of grade ⅢB tibial fractures.Method From Oct. 1985 to Oct.1999, 26 cases of grade ⅢB tibial fractures were treated by early soft tissue coverage(including 12 cases of free muscle flaps and 14 cases of local muscle flaps), early fracture fixation(including 21 cases of external fixation and 5 cases of non-reamed intramedullary nail) and early bone grafting(15 cases).Results The follow up duration were from 10 to 32 months with an average of 15.5 months. The success rates of free and local muscle flaps were respectively 91.7 %(11/12) and 92.9 %(13/14)?Infection occurred in 5 cases (3 cases of local superficial infection and 2 cases of osteomyelitis). The time for bone union were from 17 to 66 weeks with an average of 42 weeks. Conclusion "San-Zao"therapy,especially early soft tissue coverage and early fracture fixation is on effective management for grade ⅢB tibial fractures with the advantages of promoting wound healing and bone union and decreasing the possibility of infection.

Objective To structure a preliminary indicators system for evaluating the projects of Hospital in finished phase.Methods With Delphi method,collect the experts' opinion of the importance of every item.With AHP (Analytic hierarchy process) method,calculate the weight coefficient of every item.Results The positivity of the experts was fine; The authority coefficient of two rounds were 0.859 and 0.833,the consultation results are reliable; The coordination coefficient of two rounds were 0.254 and 0.553,according to the significance test,p values were less than 0.05,indicating that the results were desirable.According to the score of every item,we got the weight index of every items based on the AHP method.Finally we structure the indicators system including 3 primary indicators and 10 secondary indicators.Conclusion The preliminary results of this study provide a reference for the performance evaluation of projects in finished phase of China-Japan Friendship Hospital.

Objective To explore the infections of human cytomegalovirus (HCMV) in chronic hepatitis C patients and the hepatic impairment in chronic hepatitis C patients co-infected with HCMV.Methods HCMV-DNA was determined by fluorescence quantitative-PCR (FQ-PCR) in 95 patients with chronic hepatitis C (observation group) and 95 healthy controls(control group) and HCMV active infections were analyzed.HCV-RNA was determined by FQ-PCR in observation group,and the difference of HCMV-DNA positive rate between high HCV-RNA(＞ 104 copies/ml) and low HCV-RNA(≤ 104 copies/ml) was analyzed.Alanine aminotransferase (ALT),aspartate aminotransferase (AST) were determined by rate method in two groups and the hepatic impairment was analyzed.Results Twenty-five cases with positive HCMV-DNA in observation group,the positive rate was 26.3％(25/95).Five cases with positive HCMV-DNA in control group,the positive rate was 5.3％(5/95).There was significant difference between two groups for HCMV-DNA (x2 =14.29,P ＜0.01).Twenty-one cases with positive HCMV-DNA in 43 cases of high HCV-RNA patients,the positive rate was 48.8％(21/43).Four cases with positive HCMV-DNA in 52 cases of low HCV-RNA patients,the positive rate was 7.7％(4/52).There was significant difference between the two (x2 =19.90,P ＜ 0.01).ALT,AST in observation group was higher than that in control group (P ＜ 0.01).ALT,AST in chronic hepatitis C patients positive for HCMV-DNA was higher than that in chronic hepatitis C patients negative for HCMV-DNA significantly (P ＜ 0.01).Conclusions HCMV in chronic hepatitis C patients becomes active again and co-infects easily.When chronic hepatitis C patients co-infect HCMV actively,hepatic is further injured.

Objective To establish a dot blot hybridization technique for rapid detection of staphylococci and methicillin-resistant staphylococci.Methods Three pairs of primers were designed according to nuc gene of staphylococcus aureus,mecA gene of methicillin-resistance,tuf gene of staphylococci.Specific DNA probes were synthesized by polymerase chain reaction and labeled with biotin.The bacterial DNA inoculated on nitrocellulose filter was hybridized with these probes.The sensitivity and specificity were detected.Results The DNA probes with 270bp,310bp and 370bp were amplified by the three pairs of primers respectively.The probes were specific.Among 50 clinical isolates of staphylococcus aureus tuf and nuc gene were all positive and mecA gene in 22 isolates were positive.Positive rate of tuf,nuc and mecA gene in 30 staphylococcus epidermidis were 100%,0 and 30% (9/30) respectively.No hybridization in other non-staphylococci occurred.The established method could detect as low as 1ng of bacterial DNA.Conclusion The dot blot hybridization is of high value in rapid,effective identification of methicillin-resistant staphylococci.

OBJECTIVE: Osteoblasts are essential for osteogenesis and bone metabolism, the in vitro culture of osteoblasts is the foundation for studies on bone metabolism and osteogenetic mechanism. Therefore, it is of great significance to study the related factors affecting it.DATA SOURCES: Related literature about the influencing factors of in vitro culture of osteoblasts were searched for in Medline from January 1980 to December 2004 with retrieval words of "osteoblasts, culture in vitro, in fluencing factors", with the language limited to English. Meanwhile, it was also searched in the CBM between January 1995 and December 2004 with the retrieval words of "osteoblasts, in vitro culture, influencing factors",with the language of the articles limited to Chinese.STUDY SELECTION: After preliminary examination, literature that met the need of this study was searched for the full text. Inclusion criteria: Factors influencing the in vitro culture of osteoblasts included ① physical factors; ② microelements; ③ growth factors; and ④ hormones.Reviews were removed from this study because of summary or repetitive research.DATA EXTRACTION: A total of 105 articles related to the influencing factors of the in vitrocul ture of osteoblasts were obtained, articles of repetitive and similar researchwere removed; thereby 17 articles were included in the study.DATA SYNTHESIS: ① Physical factors: Ionizing radiation, microgravity,external force, and oxygen pressure. ② Microelements: microelement deficiency would hinder the skeletal growth, or even lead to malformation. Osteoblastic proliferation is closely related to some microelements, mainly including zinc, aluminum, fluorine, copper, manganese, calcium, and magnesium. ③ Growth factors closely related to osteogenesis mainly consist of bone morphogenetic protein, platelet-derived growth factor, fibroblast growth factor, transforming growth factor-beta, insulin like growth factor,and osteogenic growth peptide (OGP). ④ Hormones capable of promoting the proliferation and differentiation are growth hormone, estrogen, thyroxine, parathyroxine, and glucocorticosteroid.CONCLUSION: Multiple factors are involved in the in vitro culture of osteoblasts. It is helpful to understand these influencing factors to seek an effective way for the in vitro culture ofosteoblasts that is applied in tissue engineering.

With the rapid economic growth and social development in the BRICS countries, the role of devel-opment assistance for health is becoming more and more significant. This paper describes the scales, recipient coun-tries, mechanisms and characteristics and management systems of development assistance for health in BRICS coun-tries. The paper suggests that a) it is necessary to set up a centralized international aid management agency;b) the mode of development assistance for health must be optimized;c) the scale of development assistance for health shall be increased ( over time);d) each BRIC country should use its own comparative advantages and development experi-ence to carry out development assistance for health while strengthening the cooperative power among the BRICS coun-tries;e) development assistance for health data should be more transparent and open;f) the evaluation of develop-ment assistance for health must be established and perfected.

Since the establishment of the People’s Republic of China, the development of China’s official de-velopment assistance for health has been going through three phases. To date, it has developed in many forms, inclu-ding the dispatch of medical team and the construction of health facilities. Since the market reforms, the global con-text together with the domestic socioeconomic foundations have changed; the impact of China’s relatively simple and segmented development assistance for health on the development of health systems in developing countries is limited;the effectiveness of assistance has been watered-down due to segmentation and vague management and accountability systems, as well as the lack of an overarching strategy;China’s health institutions, techniques and products suffer va-rious obstacles in their transfer to other countries where rules are dominated by western countries;compared with the increasing and multiple demands of development assistance for health from developing countries, the capacities of co-operation need to be further developed. As the paper suggests, use the “new major-country” and “new morality-in-terest” and“human oriented” concepts, as well as the ideology of“aid in order to develop, develop in order to coop-erate, so as to develop hand-in-hand” to guide China’s development assistance for health;innovate stereo-aid models to adapt to the changed foreign and domestic socioeconomic context; reform the development assistance for health management system and define rights and obligations appropriately;strengthen coordination and information sharing;link development assistance for health with global health governance to promote a maximized spillover effect;mobilize the civil society with strengthened guidance and supervision.

Iliac arteriovenous ifstula (AVF) usually manifests in a wide range of symptoms similar to typical deep venous thrombosis (DVT), which often lead to delayed diagnosis or misdiagnosis. We reported a 51-year old woman who was performed lumbar discectomy and showed a progressive abdominal distention, dyspnea, and swollen left leg. She was initially diagnosed as deep vein thrombosis and the ifnal diagnosis was arteriovenous ifstula. hTe ifstula was successfully sealed by an endovascular covered stent. No further recurrence was found atfer a half year’s follow-up. hTis article summarized the experience regarding iliac arteriovenous ifstula misdiagnosed, and discussed the differential diagnosis between arteriovenous ifstula and pulmonary thromboembolism causedby deep vein thrombosis.

Objective To explore the effects of matrine and oxymatrine on apoptosis in human hepatocarcinoma SMMC-7721 cells.Methods The MTT assay and double staining of annexin V-fluorescein isothiocyanate(annexin V-FITC)/propidium iodide(propidium iodide, PI)were used to detect proliferation and apoptosis of SMMC-7721 cells, respectively.Results When the concentrations of matrine and oxymatrine were 0.50 mg/ml, 1.00 mg/ml and 2.00 mg/ml, the proliferation inhibition rates in SMMC-7721 cells was gradually increased in a dose- and time-dependent manner,and the inhibition of matrine on proliferation were greater than that of oxymatrine in the same concentration(1.00 mg/ml)(24 h:42.39%±0.04%vs. 21.36%±0.02%;48 h: 51.69%±0.03%vs. 36.16%±0.02%;72 h: 78.98%±0.05%vs. 61.24%±0.13%;allP<0.05). When the concentrations of matrine and oxymatrine were 0.25 mg/ml, 0.50 mg/ml and 1.00 mg/ml, the apoptosis rates of SMMC-7721 cells were significantly increased;and induction of matrine in apoptosis in SMMC-7721 cells was greater than that of oxymatrine at the same time point(48 h)(apoptosis rates in 0.25 mg/ml, 4.08%±0.20%vs. 2.20%±0.18%;0.50 mg/ml: 4.32%±0.19%vs. 3.08%±0.26%;1.00 mg/ml: 9.93%±0.18%vs. 9.01%±0.20%;allP<0.05).Conclusion Matrine and oxymatrine can inhibit proliferation and promote apoptosis human hepatocarcinoma SMMC-7721 cells.

Objective To study the effect of anterolateral calf flap with extra-territorial blood supply in repairing large area of foot skin tissue injury. Methods 40 cases of arge area of foot skin tissue injury were divided into the observation group which were given anterolateral crural flap transplantation and the control group which were given anterolateral thigh flap transplantation. The wound healing condition and walking ability were observed. Results The level of wound healing, Holden walking ability and FAC walking ability were better than control group (P<0. 05). In the observation group, wound healing time was (15. 2 ± 6. 2) d and donor skin crusting time was (9. 4 ± 1. 5) d, which were less than the control group(P<0. 05). Conclusion Anterolateral calf flap with extra-territorial blood supply has positive clinical value as it can improve wound healing and walking function.