BACKGROUND:Ankle fractures combined with deltoid ligament injury are not uncommon in clinical practice, prone to misdiagnosis and missed diagnosis, resulting in ankle instability, chronic pain and traumatic arthritis. In recent years, because of the research and development of anatomy and biomechanical characteristics of deltoid ligament, the treatment and surgical methods of ankle fracture combined with deltoid ligament injury have progress and development, but it remains controversial. OBJECTIVE:To evaluate the clinical effect of suture anchor repair in the treatment of ankle fracture combined with deltoid ligament injury. METHODS: Twenty-seven patients with ankle fracture combined with deltoid ligament injury were selected between January 2010 and January 2013. The lateral maleolus and posterior maleolus fracture patients were treated with open reduction and internal fixation, and al the deltoid ligament injury patients were treated with anchor repair. The tibiofibular syndesmosis isolated patients received internal fixation with a cancelous bone screw. RESULTS AND CONCLUSION:Al 27 patients were folowed-up for 11-35 months, averagely 23 months. The evaluation according to the American Orthopaedic Foot and Ankle Society score system showed that the excelent and good rate was 74.1%. The results indicate that anchor could perfectly restore the stability of ankle joint.

Objective To investigate nurses′ learning motivation and learning satisfaction with continued education and analyze its influencing factors. Method One hundred and seventy-nine nurses were enrolled in the survey and the general information questionnaire, education participation scale and continuing education learning satisfaction scale were used in the investigation. Results The average score by nursing education participation scale was (3.26 ± 0.59), and that of continuing education learning satisfaction scale was (2.74 ± 0.48). There were statistically significant differences in age, length of employment, professional title, marital status, employment mode between the scores by the two scales (P < 0.01). Conclusions Nurses′ learning motivation and learning satisfaction with continuing education are in the medium level. Pertinent guidance such as bringing continuing education in depth and width is suggested to improve satisfaction and motivations of nurses.

BACKGROUND: BK viral infection after renal transplantation influences the prognosis of BK virus-associated nephropathy in renal transplant recipients. The disease has been widely studied in foreign countries.OBJECTIVE: This study was designed to sum up the diagnosis and treatment of BK virus-associated nephropathy after renal transplantation.RETRIVAL STRATEGY: Using the terms "renal transplantation; BK virus" in the English language, manuscripts responsible for BK virus-associated nephropathy after renal transplantation that were published from January 2000 to January 2007 were retrieved from the PubMed database. A total of 206 manuscripts were obtained and primarily screened. Inclusion criteria: studies addressing BK virus-associated nephropathy after renal transplantation. Exclusion criteria: repetitive studies.LITERATURE EVALUATION: The included manuscripts were primarily from PubMed database. Manuscripts were primarily original and review studies.DATA SYNTHESIS: BK virus can be found in the urine of 3%-40% of adult renal transplant recipients. BK virus reactivation rate is very high, but the histological manifestations of BK virus associated nephropathy are found only in a small number of renal transplant recipients. The prognosis of BK virus associated nephropathy is very poor. BK virus associated nephropathy develops into renal failure, leading to transplant loss, in 30%-50% patients. BK virus-caused renal transplant disease must be diagnosed according to histological manifestations. Viral infection should be primarily confirmed, but serological measurements have no predominant effects. Electron microscopy should be involved in the assessment of renal graft biopsy, especially when renal failure factors are unknown, as through the use of electron microscope, viral particles in the nucleus, cytoplasm and outside of the cells could be detectable. Viral antigen in the urine sample of patients with BK viruria can be detected by nucleic acid hybridization method, immunofluorescence, and ELISA. Cidofovir is an effective medicine for treatment of BK virus-associated nephropathy, but its potential nephrotoxicity, proper dose, pharmacokinetics, safety, tolerance, anti-BK viral activities have not been confirmed. So fresher study should be required for aforementioned uncertainties.CONCLUSION: BK virus-associated nephropathy has poor prognosis and should be diagnosed according to histological examinations. BK virus-associated nephropathy has been treated primarily by symptomatic supportive treatment and reducing the dose of immunosuppressive agents.

Because the rehabilitation process is too long and its effect is non-significant, stroke patients are prone to showing over-reliance on their families, being unconfident in their abilities, and they usually miscommunicate with medical staff, in fact, the reason why they have these problems is that they didn't manifest appropriate ego states, so they couldn't communicate with families and medical staff healthily,which is extremely unfavorable for stroke rehabilitation. So-called ego state is individual mentality and corresponding behavior patterns.This paper used ego state concept in transactional analysis theory to describe the change of stroke patients' ego states, and analyze the communication patterns among patients, medical staffs and families, in order to assist patients to be aware of their own ego states, and present them properly, develop healthy communication, and promote the rehabilitation of the disease in the end.

Multidrug resistance(MDR) is the leading cause of treatment failure in cancer therapy. Overexpression of the ATP-binding cassette (ABC) transporter family increases the cellular efflux, decreases the effectiveness of chemotherapeutic agents,and results in MDR. In particular,overexpression of P-glycoprotein and its encoding genes(mdr1) is the major mechanism. It is feasible for overcoming MDR by studying the factors affecting mdr1 gene expression so as to block the expression of mdr1. Pregnane X receptor(PXR) can regulate the expression of MDR proteins, suggesting that it be possible to overcome drug resistance by regulating PXR. In this paper,the relation between PXR and MDR and recent development of PXR antagonists to pharmacologically modulate PXR are reviewed. The review proposes that selectively preventing the elevation of MDR levels by regulating PXR rather than non-selectively inhibiting the MDR activity by using MDR inhibitors can be a less toxic approach to overcome drug resistance during cancer therapy.

Objective To evaluate the application status of China Disease Prevention and Control Information System of Hy?datid Disease,in which questions existed are summarized in order to promote the system update. Methods A questionnaire was designed and distributed to Inner Mongolia,Sichuan,Tibet,Gansu,Qinghai,Ningxia,Xinjiang and Xinjiang Production and Construction Corps to evaluate the application status of China Disease Prevention and Control Information System of Hydatid Disease assistant with telephone. Results The recovery rate of questionnaires was 87.5%. The statistics of closed questions showed that national application rate of the China Disease Prevention and Control Information System of Hydatid Disease was 100%,of which 15.3%were low frequency users,57.1%believed the system was necessary,28.6%considered it was dispens?able,and 14.3%believed that it was totally unnecessary. The statistics of open?ended questions indicated that 6 endemic regions suggested to increase the guidance and training,while 4 endemic regions had opinions on sharing the information of the national infectious disease reporting systems and hydatid disease prevention and control information system,and the opinions on turning monthly report to quarterly report,and increasing statistics and analysis module,and 3 endemic regions deemed that the system had logic errors and defects. Conclusion The problems of the system are mainly focused on the existence of systemic deficien?cies and logic errors,lacking of statistical parameters and corresponding analysis function module,and lacking of the guidance and training,which limits the use of the system. Therefore,these problems should be resolved.

Fifteen morphologically and structurally complete sacrum specimens of normotrophic adult females were choosen. Distances between posterior sacral foramina and median sacral crest,and between the cores of adjacent posterior sacral foramina were measured. Then statistical analysis was done so as to provide objective anatomical evidence for the surface localization of Baliao points. The average distance between Shangliao (BL 31) and median sacral crest was (2.08 ± 0.19) cm; and the average distance between Ciliao (BL 32) and median sacral crest was (1.75 ± 0.12) cm; Zhongliao (BL 33), (1.59 ± 0.15) cm; Xialiao (BL 34), (1.56 ± 0.15) cm. And the distance of S₁-S₂ was (2.36 ± 0.31) cm averagely; S₂-S₃, (1.98 ± 0.23) cm; S₃-S₄, (1.71 ± 0.18) cm. It is considered that to locate Baliao points, Ciliao (BL 32) needs to be ascertained firstly.
Acupuncture Points ; Adult ; Female ; Humans ; Meridians ; Sacrum ; anatomy & histology

Objective To understand antimicrobial resistance of Enterobacteriaceae strains and distribution charac-teristics of carbapenemase-resistant Enterobacteriaceae(CRE)in Xijing Hospital in 2015,so as to provide basis for rational use of antimicrobial agents in clinic. Methods Specimens from infected inpatients and outpatients in Xijing Hospital in January-December 2015 were performed pathogenic culture,isolation and identification. Antimicrobial susceptibility testing was performed with Kirby-Bauer method,carbapenemase confirmatory test was conducted with modified Hodge test,antimicrobial resistance of Enterobacteriaceae was statistically analyzed. Results A total of 4166 pathogenic strains were isolated in 2015,1554 (37.30% )of which were Enterobacteriaceae strains,the top 5 isolated pathogens were Escherichiacoli(E. coli),Klebsiella pneumoniae(K. pneumoniae),Enterobactercloacae (E. cloacae),Proteusmirabilis,and Enterobacteraerogenes. Of 787 E. coli strains,581(73.82% )were extend-ed-spectrumβ-lactamases(ESBLs)-producing strains;of 367 K. pneumoniae strains,182 (49.59% )were ESBLs-producing strains. E. coli and K. pneumoniae had the highest resistance rates to cefazolin,which were 93.14% and 78.48% respectively. A total of 81 (5.21% )CRE were detected,K. pneumoniae,E. cloacae,and E. coli were 41 ,27,and 13 strains respectively;strains were mainly isolated from patients in departments of neurosurgery(n=42),gastroenterology(n= 9),and neurology(n= 8). 1.02% (8/787)of E. coli and 3.27% (12/367)of K. pneu-moniae were multidrug-resistant. Conclusion Enterobacteriaceae accounted for a higher proportion of pathogenic bacteria causing HAI,the detection rate of ESBLs-producing strains remains high,the isolation rate of carbapenem-resistant Enterobacteriaceae is higher than that of last year,especially K. pneumoniae.

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Objective To investigate the changes of umbilical adiponectin(APN) levels in newborn whose mothers with gestational impaired glucose tolerance (GIGT).Methods Eighteen neonates of GIGT pregnancies and 50 controls of normal glucose tolerance (NGT) pregnancies were studied.APN concentration was qualified in the umbilical vein serum with radioimmunoassay methods.Capillary blood glucose was measured at the first hour after delivery.Results Umbilical APN level in the GIGT group was significantly higher than that in NGT group [(61.06?16.85)mg/L vs(48.04?15.47)mg/L,t=2.38 P0.05).Conclusions Umbilical serum APN levels are elevated in newborns of GIGT mo-thers.This may be due to the dysregulation of serum APN levels associate with GIGT pregnancy.More attention shall be paid to the metabolic changes of GIGT mothers and their offspring.