Distal tibial fractures (Distal tibial fracture) is a common clinical fractures type, more for high-energy damage, fracture type is more complicated. Because of the distal tibia special anatomic structure (soft tissue is less, less blood supply), if the operation method is not suitable or fixed equipment selection is not reasonable, because fracture healing, osteomyelitis, also can damage the function of the ankle joint. Treatment shall be based on the fracture position, type, in the process of the polluted situation and surrounding soft tissue trauma injury and so on many factors that determine the way and the internal fixation methods. This paper reviews recent year different types of distal tibial fracture fixation and fixed ways of literature research, in the treatment of distal tibial fracture clinical practice to provide the reference of objective reasonably select fixation and evaluation standard.

OBJECTIVE To study approaches to effective infection management,so that it can function high effectively.METHODS Some important facts were reviewed,analyzed and summarized,which had influence on hospital infection management.RESULTS The quality and knowledge of the team in charge of infection management,the organization and regulations concerned were prerequisite to effective infection management,with reasonable incentive means.CONCLUSIONS Analysis and much emphasis to be given on the facts affecting hospital infection management are key points to its improvement.

Objective:To analyze dynamic change and severity of IL-1 beta, TNF alpha, COX-2 detected by automatic enzyme immunoassay analyzer on patients with acute gout.Methods: Ninety cases of acute gout patients selected according to the different degrees of severity, and were divided into three observed groups. Thirty health people were treated as the control group. IL-1β, TNF-α, COX-2 levels of dynamic change were recorded and compared within the four groups of patients.Results: The serum IL-1β, TNF-α, COX-2 levels in the 1st, 3rd, 7th, 10th day in the observation group 1 and group 2 in acute gout attacks were significantly higher than the control group; The serum levels of IL-1β, TNF-α, COX-2 levels in the 7th 10th day in observation group 1 in acute gout was significantly higher than observation group 2; The serum IL-1β, TNF-α,COX-2 levels in observation group 3 have not significant difference with control group 2; The serum IL-1β, TNF-α, COX-2 levels in observation group1,2,3 in acute gout attacks in the 14th days have not significant difference with control group.Conclusion: After analgesic drugs for the treatment of acute gout patients from 10 to 14 days, the inflammatory cytokines can be completely back to normal. The results provided important evidence for the introduction of analgesic drugs in patients with acute gout treatment.

Leukemia is one of the common tumors,and it seriously harms to the health.The more serious environmental pollutions become,the more people pay attention to the relationship between environmental exposures and leukemia,especially children leukemia.To discuss the progress of study on formaldehyde and leukemia,this study states the characteristics of formaldehyde,the resources of formaldehyde indoor air and the harms to health,toxicity and human cancinogenicity,and reviews the researches on the relationship between formaldehyde and leukemia.It concludes that there is "strong but not sufficient evidence for a causal association between leukemia and occupational exposure to formaldehyde".

AIM:To further study the anti-tumor effect of angiostatin, an anti-human angiostatin monoclonal antibody was prepared and identified.METHODS:The hybrodoma techniques were used. The BALB/C mice were immunized with angiostatin. The supernatant of cell culture were collected and screened by ELISA and double immunodiffusion.RESULTS: There cell lines which steadily secreted the anti-angiostatin monoclonal antibody were identified by ELISA and double immunodiffusion. The antibody was IgG1 and specifically recognized angiostatin without crossing reactions to rhIL-2, rhTNF-?, rhIFN-? and serum proteins.CONCLUSION: The antibodies secreted by three hybridoma cell lines identified by several methods were specific antibodies of angiostatin.

BACKGROUND:The application of virtual reality technology in preoperative simulation can reduce the risk in operation effectively and improve the quality of surgery. Virtual reality technology has very important practical significance in the application of surgery. OBJECTIVE:The reverse engineering and virtual reality technology were used to achieve the preoperative simulation of a case of Pilon fracture. METHODS:The affected bones were reconstructed according to the CT data using the patient’s ankle portion in MIMICS software, and the separated bone fractures were restored. According to the characteristics of virtual reality technology, further processing on bone model was carried out using Geomagic software;the models of the fractured bones were exported with STL format. The restored bone fragments were checked up to determine integrity in the virtual reality operation platform. These models were used to do simulated operations in the virtual reality operation platform. RESULTS AND CONCLUSION:A case of Pilon fracture was simulated by using reverse engineering and virtual reality technology preoperatively. The processed 3D model was introduced into the virtual reality system to simulate the operation and help doctors choose the type, position and direction of the surgical approach and plate;the effect is good.

BACKGROUND:Dexamethasone can improve the cellapoptosis and decrease the number of osteoblasts and bone cells through increasing the time of cellcycle. Protein kinase C is a kind of intraecellular singnal transduction pathways, and there are related reports on the relationship between protein kinase C and cellapoptosis. OBJECTIVE:To investigate the mechanism of dexamethasone-induced osteoblast apoptosis via protein kinase C intracellular signal transduction pathway. METHODS:Fetal rat bone marrow mesenchymal stem cells were col ected for osteogenic induction, and the cells were divided into dexamethasone group, phorbol group and star cytochalasin group. The cells in the dexamethasone group were added with 1×10-6 mol/L dexamethasone, the cells in the phorbol group were added with 1×10-6 mol/L dexamethasone and 1×10-7 mol/L phorbol, while the cells in the star cytochalasin group were added with 1×10-6 mol/L dexamethasone and 1×10-7 RESULTS AND CONCLUSION:Dexamethasone could induce apoptosis significantly, and after added with mol/L star cytochalasin. The proliferation and inhibition of the cells in different intervention groups were observed, and the content of protein kinase C in the cellmembrane and cytoplasm was measured. phorbol, the apoptosis was increased significantly;while after added with star cytochalasin, the apoptosis was decreased significantly. After added with dexamethasone, the content of protein kinase C in the cytoplasm was significantly decreased, while increased in the cellmembrane. At different time points after added with dexamethasone, the change of the content of protein kinase C in the cytoplasm and cellmembrane was most significant at 30 minutes. The results indicated that mechanism of dexamethasone-induced osteoblast apoptosis was correlated with protein kinase C, and dexamethasone was the agonist of protein kinase C. After the cells were stimulated, the protein kinase C in the cytoplasm wil moved to the cellmembrane, and then the content of protein kinase C in the cytoplasm was decreased, while increased in the cellmembrane.

Objective To investigate Zunyi C Class infectious diseases ,and provide basis for formulating prevention and control measures .Methods A network report of class C infectious diseasesfrom in Zunyi city from 2009 to 2012 was statistically analyzed by Excel software ,and data analysis was conducted by descriptive epidemiological method for .Results In Zunyi city from 2009 to 2013 reported a total of 8 kinds of class C infectious diseases (68 915 cases) ,annual report incidence rate was 213 .23/10 million;the top three are hand foot and mouth disease ,mumps and other infectious diarrhea ,accounted for 62 .22% of the total reported ca‐ses ,19 .68% and 13 .44% .There was slightly higher incidence rate of the disease from March to August and the main risks were in scattered children ,kindergarten children and students ;the age of onset lie in the population under 14 years old ,the male to female ratio was 1 .67∶1 .00 (χ2 =3 445 .64 ,P<0 .01) .Conclusion Hand foot and mouth disease ,mumps ,other infectious diarrhea and other infectious disease has become an important public health problem in Zunyi city .Therefore ,the kindergarten ,school infectious disease epidemic monitoring should be strengthened ,the infectious disease outbreaks should be reduced ,and communicable disease diagnosis and reporting standards ,which is helpful to improve the epidemic situation of infectious diseases research and prevention and control level should be improved to maintain the protection of public health .

Objective To analyze the risk factors associated with morbidity and mortality of aortic dissection through the retrospective analysis.Methods Two hundred and thirty-two patients with aortic dissection(AD) who were treated in the Central Hospital of Taian were select as cases group,and were divided into A group of dissection involved ascending aorta with 91 cases and B group of dissection not involved ascending aorta with 141 cases according to type of Stanford.And 232 cases patients with chest pain in the same period of hospitalization and exclusion of aortic dissection were randomly selected as the control group.Through the history data collection,the relationship between age,sex,smoking and drinking history,history of previous illness,family history of cardiovascular disease,predisposing factors and the incidence of AD,and the difference of risk factors between A type and B type were analized.Single factor and multi factor Logistic regression analysis were performed on part of the related factors in the case group.Results Smoking history,hypertension history,coronary atherosclerotic heart disease history,Marfan syndrome and hyperuricemia of cases group were higher than of control group (x2 =6.165,11.700,9.260,14.070,35.170;P＜ 0.05).Marfan syndrome,coronary atherosclerotic heart disease history and hyperlipidemia history of A group were higher than of B group,hypertension history of B group was higher than A group,and the differences were significant (x2 =3.998,4.534,7.308,7.827;P＜0.05).In the correction of other factors,the risk of death in patients with type A was 3.27times that of the B type(P＜0.001),the risk of death in patients with a history of hypertension were 1.48 times more than that without history of hypertension(P=0.014),the risk of death in patients with hypotension shock were 2.27 times more than that without hypotension shock (P ＜ 0.001).Conclusion History of smoking,history of hypertension,history of coronary heart disease and hyperuricemia are the risk factors of aortic dissection.A aortic dissection type,a history of hypertension,and hypotension or cardiogenic shock are the independent risk factors causing the death of patients with aortic dissection.