Objective To investigate the internal fixation for distal humeral fractures and its outcome .Methods A total of 74 patients with distal humeral fractures were performed surgical operation between Jan 2006 and Jun 2009 .According to AO/ASIF classification ,the factures were classified as type A (n=26) ,B(n=34)and C(n=14) .Internal fixation was applied to the patients , who did functional exercises after operation ,on the basis of classification .The healing of the fractures and the function the joints was examined via follow-up and X-ray films 1 ,3 and 6 months after operation .Results According to the Jupiter elbow score ,40 ca-ses were excellent ,22 cases were good ,12 cases were fair and 0 case was poor ,and the good rate was 83% .Conclusion Internal fix-ation with double plate ,is an effective therapeutic approach to distal humeral fractures in adults .Influencing factors of the efficacy include severity of the initial trauma ,operative scheme ,and post-operation functional recover .

Objective To prepare gensenosides microbore osmotic pump tablet, and to investigate releasing in vitro. Methods We prepared gensenosides microbore osmotic pump tablet to investigate the release in vitro by cumulative release rate in different time. Results We prepared gensenosides microbore osmotic pump tablet successfully and investigated releasing in vitro and drew the release curve. Conclusion The release of gensenosides microbore osmotic pump tablet in vitro consists with zero order release rule. It can chalk the effect in ten hours.

Objective Weifang is a pilot of the health system reform, the research aims to investigate the present situation of turnover intention within the medical staff in Weifang's public hospitals, seeking main influencing factors, while exploratory research about how to bulid a three-stage early-warning system also included. Methods Chooseing 29 public hospitals with stratified random sampling method, questionare investigation for 933 qualified samples,and spss 16. 0 was also used as an analysis method. Results About 49% of the respondents have turnover intention, those working years less than 10 have the strongest turnover intention, individual work-emotional exhaustionsocial support from family members or friends, and restriction of personal development are three main causes from Logistic analysis. Conclusion According to the stage characteristic of turnover intention, building an early-warning system could play an important role in controlling brain-drain.

AIM: To isolate, purify and differentiate endothelial progenitor cells from cord blood in vitro and to study their biological characteristics. METHODS: CD133~+ cells were selected from fresh cord blood mononuclear cells (MNC) by magnetic activated cell-sorting system (MACS). EPC was studied by flow cytometry, immunocytochemistry and immunofluorescence staining. Isolated cells were cultured in IMDM medium supplemented with or without VEGF, bFGF, SCF. RESULTS: The percentage of CD133~+ cells of cord blood MNC was (1.41?1.14)%, and purity was 75%-85% (FACS method). CD133~+ cells were grown on fibronectin-coated chamber slides in the presence of VEGF, bFGF, SCF. Within 1-2 hours of culture cells became adherent. On day 7-10, the adherent cells displayed a typical "cobblestone" morphology. After 14 days of culture, the adherent cells revealed a heterogeneous cell population, comprising small-sized round cells, spindle-like cells and formed tube-like structure. Weibel-Palade bodies were shown on the transmission electron microscopy photomicrographs. Compared with the (original,) cell markers CD133 and CD34 decreased significantly (77.0%?3.3% to 1.6%?2.2% and 93.1%?4.7% to 37.4%?4.9%, P

An efficient modified route based on the targeting mechanism of antibacterial fluoroquinolones for the shift from the antibacterial activity to the antitumor one was further developed. Using a fused heterocyclic ring, s-triazolothiadiazine as a carboxyl bioisostere of ciprofloxacin, the title compounds, 1-cyclopropyl-6-fluoro-7-piperazin-1-yl-3-(6-substituted-phenyl-7H-[1, 2, 4]triazolo[3, 4-b][1, 3, 4]thiadiazin-3-yl)-quinolin-4(1H)-ones (5a-5e) and their corresponding N-acetyl products (6a-6e), were designed and synthesized, separately. Meaningfully, a ring-contraction of fused six-membered thiadiazine occurred by a sulfur extrusion reaction gave new tri-acetylated fused heterocycles related to pyrazolo[5, 1-c][1, 2, 4] triazoles (7a-7e). The in vitro antitumor activity against L1210, CHO and HL60 cell lines was also evaluated for the synthesized fifteen heterocycles compared to parent ciprofloxacin by methylthiazole trazolium (MTT) assay. Interestingly, the results displayed that fifteen fused heterocyclic compounds showed more significant growth inhibitory activity (IC50 < 25.0 micromo x L(-1)) than that of parent ciprofloxacin (IC50 > 150.0 micromol x L(-1)), and the active order decreased from 7a-7e to 5a-5e to 6a-6e, respective.

Objective To observe the clinical efficacy of electroacupuncture plus oral administration ofZeling Guanjie Xiaozhong Heji in treating rheumatoid arthritis (RA) due to liver-kidney yin deficiency.Method Totally 126 patients with active RA due to liver-kidney yin deficiency were randomized into a treatment group and a control group, 63 cases in each group. The control group was prescribed with orally taking Methotrexate tablets and Leflunomide tablets, while the treatment group was intervened by electroacupuncture plus oral administration ofZeling Guanjie Xiaozhong Heji in addition to the medications given to the control group. The Disease Activity Score 28 (DAS28) was evaluated before and after intervention, and the therapeutic efficacies were compared based on the criteria of the American College of Rheumatoid (ACR) and syndrome of traditional Chinese medicine (TCM).Result The ACR total effective rate was 87.3% in the treatment group versus 65.1% in the control group, and the difference was statistically significant (P<0.01). The total effective rate based on TCM syndrome was 87.3% in the treatment group versus 73.0% in the control group, and the difference was statistically significant (P<0.05). There was a significant difference in comparing the DAS28 score between the two groups after intervention (P<0.01).Conclusion Electroacupuncture plus oral administration of Chinese medication and western medication is an effective approach in treating RA due to liver-kidney yin deficiency, and it can significantly enhance the therapeutic efficacy based on ACR20 and TCM syndrome.

Objective To evaluate the geometric and dosimetric accuracy of autosegmentation software for contouring the organ-at-risk ( OAR) of esophageal cancer, and discuss its clinical feasibility. Methods A total of 10 patients were enrolled, and single and multi-template were adopted respectively to auto-delineate corresponding OARs on target CT images based on image registration. The geometric consistency including volume difference (ΔV) , dice similarity ( DSC) and position difference (Δx, Δy,Δz) between the two autosegmentation method and manual were compared using Wilcoxon signed-rank test. And the correlation between DSC and OAR volume was analyzed. In addition, to evaluate the clinical feasibility of autosegmentation, the dose distributions of all OARs were compared using Friedman test. Results The average DSC of all OARs obtained by single and multi-template were 0.82 ± 0.17 and 0.92 ± 0.54, respectively, with statistically significant difference (Z= -2.803- -2.497, P<0.05). A positive correlation between DSC of the autosegmentation and OAR volume was found by spearman analysis, and the single-template was not good enough for the spinal cord with smaller volume. The positional deviations of multi-template group were less than 0.5 cm in three directions, which were better than single-template group. The main dosimetric indexes of single-template and multiple-template were similar to manual coutours. V20 of whole lung were 23.2％, 22.4％ and 22.1％, Dmeanof whole lung were (11.3 ±4.0), (11.1 ±4.5) and (11.0 ±4.3) Gy, Dmaxof spinal cord were (40.3 ±4.8), (38.2 ±6.7) and (39.4 ± 5.3) Gy, respectively, and V30 of heart were 16.0％, 15.8％ and 15.5％, respectively. There was no statistical difference between the three methods (P>0.05), and all of the dosimetric indexes were in line with the requirements of clinical dose limits. Conclusions The autosegmentation software can achieve satisfactory precision for the OARs of the esophageal cancer patients, and the multi-template method is better than the single-template, which is more suitable for clinical application.

Objective To investigate the serum 25-hydroxy vitamin D concentrations and related factors in early pregnancy. Methods Plasma was collected in the first trimester from 23 396 pregnant women to inves-tigate the vitamin D level, and its distribution and differences in different age, body maxx index ( BMI) and seasons between primipara and multipara. Preterm birth was used as an indicator of clinical outcomes. Vitamin D concentrations were measured using chemiluminescence microparticle immunoassay. Results 25-hydroxy vi-tamin D level was 42. 0 (17. 6-76. 6) nmol/L in totally 23 396 pregnant women with early pregnancy, and 5% and 95% percentile sites of vitamin D level were 20. 2 nmol/L and 70. 7 nmol/L respectively. There were 18 170 (77. 7%) primiparas and 5 226 (22. 3%) multiparas, with the mean age of 30. 0 (24. 0-38. 0) years and BMI of 20. 7 (16. 5-27. 6) kg/m2. The number of cases detected in spring (March, April and May), summer (June, July and August), autumn (September, October and November months) and winter (Decem-ber, January and February) were 5 878, 5 554, 5 974, and 5 990, respectively, and the vitamin D levels were 40. 0 (29. 3, 52. 7) nmol/L, 46. 2 (35. 6, 57. 2) nmol/L, 43. 8 (33. 1, 54. 8) nmol/L and 37. 2 (26. 9, 49. 9) nmol/L respectively, with the difference in vitamin D levels statistically significant among the four seasons (P<0. 001). According to BMI, all pregnant women were divided into four groups as BMI<18. 5 kg/m2, 18. 5 kg/m2≤BMI≤23. 9 kg/m2, 24 kg/m2≤BMI≤27. 9 kg/m2, BMI≥28 kg/m2, and the levels of 25-hydroxy vitamin D were 43. 5 (30. 9, 56. 9) nmol/L, 42. 1 (30. 8, 53. 8) nmol/L, 39. 9 (30. 7, 50. 4) nmol/L and 39. 7 (30. 7, 49. 4) nmol/L respectively with the difference statistically significant among the four groups. The levels of vitamin D detected in pregnant women with age<25 years, 25~29 years, 30~34 years,≥35 years were 39. 1 ( 28. 4, 52. 3) nmol/L, 41. 3 ( 30. 1, 52. 9) nmol/L, 42. 4 ( 31. 2, 54. 1) nmol/L and 43. 8 (31. 9, 55. 7) nmol/L respectively and the difference was statistically significant (P<0. 001). The levels of 25-hydroxy vitamin D in primary and multiparas were 41. 6 (30. 2, 52. 9) nmol/L and 43. 5 (32. 5, 56. 8) nmol/L with the difference statistically significant (P<0. 001). Among women of different gestational age during childbirth, the differences in serum 25-hydroxy vitamin D in early pregnancy were not statistically significant (P=0. 121). The severe deficiency of vitamin D in early pregnancy was defined as serum level of 25-hydroxy vita-min D less than 5th level. There were statistical differences in the probability of severe vitamin D deficiency of dif-ferent ages, seasons and BMI between primiparas and multiparas. Conclusions Pregnant women of lower weight, lower age and primiparity have higher incidence of the severe vitamin D deficiency in early trimester of pregnancy. There is significant difference in 25-hydroxy vitamin D level among the different seasons (winter

Objective To analyze the clinical features and validation of Brighton criteria in Guillain-Barré syndrome (GBS) patients from southern China.Methods The clinical data of hospitalized GBS patients from 69 hospitals of 14 provinces/cities in southern China,the area south of the Huaihe River,between 1 January 2013 and 30 September 2016,were collected and analyzed retrospectively,and patients were classified according to the Brighton criteria of case definition,ranging from a highest (defined as level one) to a lowest (level four) level of diagnostic certainty.Results A total of 1 358 GBS patients were collected,including 51 cases with cranial nerve variants,157 with Miler-Fisher syndrome and 1 150 with classic GBS characterized by flaccid weakness of limbs.Among 1 150 cases of classic GBS,49.57％ (570/1 150) patients had antecedent events,with respiratory infection predominated (71.23％,406/570);83.74％ (963/1 150) presented limb weakness at onset,99.21％ (1 124/1 133) reached the peak within four weeks,with a score of 3.15 ± 1.16 for Hughes Disability Scale;99.56％ (1 128/1 133)developed bilateral weakness and 95.39％ (1 097/1 150) manifested flexia or hyporeflexia;the cerebrospinal fluid showed albuminocytologic dissociation in 80.58％ (772/958) patients whose lumbar puncture was performed;demyelinating GBS accounted for 48.14％ (401/833) and axonal subtype 18.01％ (150/833) respectively in patients with findings of nerve conduction studies available.According to Brighton criteria,the patients were stratified as level one in 44.09％ (507/1 150),level two in 45.74％ (526/1 150),level three in 7.57％ (87/1 150) and level four in 2.61％ (30/1 150) of all the patients,and 69.55％ (507/729),28.67％ (209/729),0％ (0/729) and 1.78％ (13/729),respectively in the patients with complete data (n =729).Conclusions In southern China,demyelinating subtype of GBS is predominant,whereas the proportion of axonal subtype is remarkably lower than that in northern China.The Brighton criteria have a high sensitivity for the diagnosis of GBS in southern China,and examination of cerebrospinal fluid and electrodiagnostic studies are necessary for stratified diagnosis.

Objective:To investigate and compare the clinical outcomes of the arterial pre-occlusion technique(APOT) and the traditional technique in the surgery of locally advanced pancreatic cancer with arterial involvement after conversion therapy.Methods:This is a retrospective cohort study. The clinical data of 145 patients with locally advanced pancreatic cancer with arterial involvement admitted to the Department of Hepato-Biliary-Pancreatic Surgery of the First Hospital Affiliated to Naval Medical University,from January 2020 to December 2022 were retrospectively analyzed. All patients completed neoadjuvant therapy for tumors, and the feasibility of radical surgical treatment was determined by a multidisciplinary collaborative team evaluation before surgery. According to whether the intraoperative artery was pre-occluded, 145 patients were divided into two groups, including 28 cases in the APOT group(16 males, 12 females, aged (59.0±9.4) years), and 117 cases in the routine surgery group(76 males, 41 females, aged (55.1±8.2) years). To ensure comparability of baseline data between the APOT group and the routine surgery group, a 1∶2 match was performed using the propensity score matching method, and the caliper value was 0.006 45. The t-test,the Mann-Whitney U test, χ2 test or Fisher′s exact test were used to compare the data between the two groups,respectively. Results:After matching the propensity score,there were 28 cases in the APOT group and 56 cases in the routine surgery group. There were no significant differences in gender,age,preoperative comorbidities,preoperative body mass index,surgical approaches,chemotherapy regimen,stereotactic body radiation therapy ratio,tumor markers,and type of invaded artery between the two groups (all P>0.05).The arterial occlusion time M(IQR) in the APOT group was 7.0(3.8)minutes(range:3 to 15 minutes),and no ischemic manifestations were observed in the distal target organs that blocked blood vessels after surgery. The operation time was (170.3±57.7)minutes in the APOT group and (235.0±80.2)minutes in the routine surgery group,and the difference was statistically significant ( t=-3.800, P<0.01). The APOT group also experienced less intraoperative blood loss(650(588)ml vs. 800(600)ml; U=1 026.500, P=0.021). No significant differences were found between the groups in combined vein resection and reconstruction,celiac trunk resection,early postoperative complications, readmission rates at 30 days,and postoperative length of stay(all P>0.05). Extra-arterial dissection was performed in all patients,with arterial resection and reconstruction in 3 cases: 2 cases in the APOT group(1 case involving the superior mesenteric artery and 1 case involving the common hepatic artery) and 1 case in the routine group(involving the common hepatic artery). Postoperative abdominal bleeding occurred in 4 cases,with 3 cases in the routine group,1 case in the routine group. The R0 resection rate was 85.7%(24/28) in the APOT group and 80.4%(45/56) in the routine group,without significant differences between the groups( P=0.763). The median overall survival time was 27.6 months for the APOT group and 22.5 months for the routine group,while the median disease-free survival was 11.7 months and 16.8 months,respectively,with no significant differences between the two groups( P=0.532, P=0.927). Conclusion:The arterial pre-occlusion technique can be used for extra-arterial dissection in patients with locally advanced pancreatic cancer involving the arteries,reducing surgery time and intraoperative blood loss.