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.

Communicable Diseases ; epidemiology ; transmission ; Environmental Monitoring ; Epidemiologic Factors ; Forecasting ; Humans ; Models, Theoretical ; Risk Assessment

Objective To investigate the prevalence of cervical spondylosis among adults in Beijing.Methods The prevalence of cervical spondyiosis among people older than 18 years who had lived in Beijing for more than six months was investigated in December 2010.The multi-stage sampling was used in this cross-sectional study.The related information was obtained by a self-designed questionnaire.Single and muhivariable Logistic regression models were applied to analyze high risk districts and populations.Results A total of 3859 people were enrolled in this study.Among them there were 531 people with cervical spondylosis,and the prevalence was 13.76％.The prevalence of cervical spondylosis in suburb (15.97％) was the highest compared with city center and countrysides (x2=8.257,P=0.016).The prevalence in females (10.49％) was higher than that (16.51％) in males (x2=29.432,P＜0.001).The distribution of prevalence among different age populations was inverted U shape,and the prevalence was higher in 45 years group (20.43％) and 60 years group (18.91％) compared with other two groups.The prevalence in employed group was 1.303 times higher than that in unemployed group (95％CI:1.008,1.684).According to the muhivariable logistic regression result,suburb (OR=1.306,P=0.026),females (OR=1.81 1,P＜0.001),people who were 45years or 60 years (OR=2.171,P＜0.001; OR=2.430,P＜0.001,respectively) and employed and retired people (OR=1.664,P=0.001; OR=1.303,P=0.043,respectively) were high risk population of cervical spondylosis.Conclusion The prevalence of cervical spondylosis among adults in Beijing was much higher and vastly distributed.It's necessary to reinforce the prevention,diagnosis and treatment study.Young females,people aged 45 years or 60 years,and employed people were high risk populations.

Objective To investigate the prevalence of low back pain among adults in Beijing.Methods The study design was a cross-sectional study,and the multi-stage sampling was used.A questionnaire survey was conducted in December 2010 to investigate prevalence of low back pain in adults who had lived in Beijing for over 6 months.Total prevalence and prevalence by region,gender and age were calculated.The chi-square test was used to compare results.Results A total of 3860 people were enrolled in this study.The one-year prevalence of low back pain was 26.09％ (1007/3860),and the point prevalence was 6.11％ (236/3860).The prevalence of different duration of low back pain (3 months,3-6 months,≥6 months) was 16.76％ (647/3860),4.12％ (159/3860) and 5.21％ (201/3860),respectively.The prevalence of females (28.83％) was higher than that of males (23.03％).The prevalence among different regions was significantly different.Prevalence in suburb and rural area (29.88％ and 27.54％,respectively) was higher than that in urban area (20.88％).No matter males or females,the prevalence in urban area was the lowest (17.48％ and 24.00％,respectively).With the increasing of age,the prevalence of low back pain became higher.In males,the prevalence of 55 to 59 years group was highest,while 60 to 64 years group was highest in females.In urban area and rural area,the prevalence of 60 to 64 years group was highest (34.43％ and 48.68％,respectively),while 55 to 59 years group was highest in suburb (47.26％).Conclusion The oneyear and point prevalence of low back pain among adults in Beijing are higher,with wide distribution.The chronic low back pain is more common.The prevalence of low back pain is higher in suburb and rural area.Females have a higher prevalence than males.Moreover,the prevalence of low back pain increases with age.

Objective To evaluate the imaging findings and its pathologic basis of intrahepatic peripheral cholangiocarcinoma(IHPCC).Methods 25 patients with pathologically proven IHPCC were reviewed retrospectively.B-ultrasonic scanning (BUS) was performed in allpatients.CT(including conventional unenhanced and enhanced scan) was done in 21 patients.11 patients received MRI with dynamicscannings.9 patients underwent digital subtraction angiography(DSA).Results 15 patients were hypoecho and 10 patients were brieflyhyperecho or hyperecho in BUS, homogeneous or heterogeneous. On unenhanced CT, the lesions were of low density with ill-definedborder. The lesions were low intensity on T1WI and moderately high intensity with low intensity in central area on T2WI . Dynamic CT and MRI showed gradually enhancement from the periphery toward the center of the lesion in most patients. Focal dilatation and calculus of the intrahepatic bile ducts around the tumor could be seen and retraction of liver capsule could also be seen in imaging appearance of IHPCC. On selective DSA ,the lesions were resemble to the tumors with rare blood vessels ,on superselective DSA, tumor vascular plexus were tiny and like “flocculus” in arterial period, obvious staining with ill-defined during parenchymal phase in 9 patients. Pathologically,tumor vessels were rare, these were plenty of interstitial fibrous tissue between tumor cells. Conclusion The imaging features of intrahepatic peripheral cholangiocarcinoma are of certain characteristic.

Objective To investigate the prevalence and distribution of lumbar degeneration disease among adults in Beijing.Methods The study design was cross-sectional study.The multi-stage sampling was used.The study objects were residents who were lived in Beijing over six months and older than 18 years.The related information was obtained by self-designed questionnaire.Single and multivariable Logistic regression models were applied to analyze the high risk populations.Results A total of 3186 people were studied.There were 292 people who suffered lumbar degenerational disease.The prevalence was 9.17％.The prevalence at downtown,suburb county and rural area was 7.88％,10.20％,and 9.59％,respectively,and there was not significant difference (x2=3.545,P=0.170).The prevalence of female (10.05％) was higher than male (8.13％) (x2=4.081,P=0.043; OR=1.337,95％CI:1.044,1.713).The prevalence of the population who was not less than 45 years older was significant higher than that of the population less than 45 years older (x2=102.982,P＜ 0.001).The physical labor group (12.16％) had higher risk for lumbar degeneration disease compared with mixed group (6.65％)(OR=1.510,95％CI:1.102,2.071).There were no significant differences in different education,social insurance,and income populations.Conclusion The prevalence of lumbar degeneration disease among adults is much higher and vastly distributed.It's necessary to reinforce the prevention,diagnosis and treatment study.People of female,more than 45 years older and physical labor group are high risk populations.