Objective To evaluate the method, clinical effects and influential factors of using three dimensional external fixators in the treatment of severe open comminuted tibiofibular fractures 5 cm near the knee or ankle joints. Methods We retrospectively analyzed 32 cases of open comminuted tibiofibular fracture 5 cm near the knee (11 cases) or ankle joints (21 cases). They were treated with three dimensional external fixators from October 2000 to May 2005. The patients with small wounds were treated with manipulative reduction or leverage reduction through the wound under the guidance of C-arm radiography. In case of malreduction or soft tissue being tangled by the fracture ends, visible reduction was carried out after the wound was lengthened or a small incision was added. Limited internal fixation was used in case of necessity. The results were evaluated in terms of shortening of the fractured limbs, X-ray manifestation, bilateral flexion differences and postoperative walking complaints. Results Follow-ups from 5 to 18 months (nine months on average) showed that all the cases achieved osseous union. The mean union time was 5.6 months. The total excellent and good rates of fracture healing and functional recovery were 81.3% and 87.5% respectively. Conclusion Application of the three dimensional external fixator is appropriate for the treatment of severe open comminuted tibiofibular fracture 5 cm near the knee or ankle joints, because its operative procedure is simple, the injury it causes is minimal, its fixation is reliable and its complications are quite limited.

Objective To investigate the expression and clinical significance of Sir2?related enzymes?1(SIRT1)in colorectal cancer. Methods The expression of SIRT1 was evaluated by immunohistochemistry in 86 selected cases of primary Colorectal cancer and 30 samples of normal rectum tissues besided carcinoma. The relationship of the expression and clinical pathological features were analyzed. Results The positive expression rate of SIRT1 in Colorectal cancer tissue was 88.4%,and significantly higher than in normal rectum tissue besided carcinoma(P<0.001). There were no correlation between the expression of SIRT1 and sex,age and tumor diameter,and significant positive correlation between the expression of SIRT1 and TNM stage (P<0.05),lymph node metastasis(P<0.05),infiltrating depth(P<0.05),and negagtive correlation between the expression of SIRT1 and tumor differentiation(P<0.05). Conclusion The positive expression rate of SIRT1 in colorectal cancer tissue was significantly higher than in normal rectum tissue besided carcinoma and intimate correlation with tumor differentiation,TNM stage,lymph node metastasis and Infiltrat?ing depth. Conclusion SIRT1 may be an important assistance gene to diagnose and judge prognosis,and may improve diagnostic rate and auxiliari?ly judge prognosis as a important Colorectal cancer marker.

OBJECTIVE:To investigate therapeutic efficacy and safety of levamlodipine and telmisartan combined with hydro-chlorothiazide in the treatment of anti-dipper hypertension. METHODS:Totally 150 patients with anti-dipper hypertension were ran-domly divided into group A,B,C,with 50 cases in each group. Group A was given Telmisartan tablet 40 mg+Hydrochlorothiazide tablet 10 mg,once a day,in the morning. Group B was given Levamlodipine tablet 5 mg,once a day,in the night. Group C was given Telmisartan tablet(usage and dosage same as group A)+Hydrochlorothiazide tablet(usage and dosage same as group A)+Le-vamlodipine tablet(usage and dosage same as group B). Treatment courses of 3 groups lasted for 8 weeks. The changes of electro-lyte and 24 h ambulatory blood pressure were observed and compared among 3 groups before and after treatment. The incidence of adverse reactions was recorded. RESULTS:There was no statistical significance in the electrolyte indexes in 3 groups before and af-ter treatment(P>0.05). Before treatment,there was no statistical significance in 24 h blood pressure among 3 groups(P>0.05). Af-ter treatment,the 24 h blood pressure of the patients in the 3 groups after treatment was lower than before treatment,and group C was lower than that of the group A and group B(P<0.05). After treatment,the rate of anti-dipper rhythm reversal in group C was significantly higher than group A and B,with statistical significance(P<0.05). There was no statistical significance in the inci-dence of ADR among 3 groups(P>0.05). CONCLUSIONS:Levamlodipine and telmisartan combined with hydrochlorothiazide show good therapeutic efficacy for anti-dipper hypertension,and can reduce 24 h blood pressure and effectively reverse anti-dipper rhythm with good safety.

ncing analysis validated that all four-type base-quenched probes could provide unbiased genotyping results ( Kappa =1, P=0.00), although. Conclusion This method is simple, economic and suitable for large-scale genotyping studies.

Objective To investigate the therapeutic effect and side effect of prourokinase (Pro-uk) on the patients with acute myocardial infarction. Method From May 2004 to May 2005, a total of 68 cases of acute myocardial infarction treated by thrombolytic agents within 6 hours after onset were divided randomly into Pro-uk group ( n = 43) and urokinase (UK) group ( re = 25). In the Pro- uk group, there were 22 eases treated with 50 mg Pro-uk and 21 cases prescribed in 60 mg Pro-uk. The patency of involved coronary artery was evaluated by using selective coronary angiography at 90 minutes after thrombolytic therapy. The incidence of early heart events, bleeding and adverse reaction, were alse observed. Results (1) The total rates of resumed patency of obstructed coronary artery (TIMI grade 2 and 3 flow) were 76.7% in Pro-uk treated patients and 52.2% in UK treated patient ( P = 0. 041). (2) The occurrence of hyporrhea was lowered more significantly in Pro-uk treated patients than in UK treated patients (P = 0.029), but there were no intracranial hemorrhage found in both group. (3) Early cardiac events and adverse reactions were similar between two groups. Conclusions Pro-UK is safe and effective for the patients with acute myocardial infarction.

Objective To investigate the expression and clinical significance of silent mating type information regulation 2 homolog-1(SIRT-1)and nuclear factor-κB(NF-κB)in non-small cell lung cancer (NSCLC). Methods The expressions of SIRT-1 and NF-κB were evaluated by immunohistochemistry in 108 selected cases of primary NSCLC and 48 samples of para-carcinoma normal tissue. The relationships of the expressions of SIRT-1 and NF-κB and clinical pathological features were analyzed,respectively. Results Immunohistochemical results showed that the positive expression rates of SIRT-1 and NF-κB in NSCLC tissue were 90. 7%(98 / 108)and 94. 4%(102 / 108),respectively,significantly higher than those in normal lung tissue 4. 2%(2 / 48),16. 7%(8 / 48),χ2 = 108. 237,P = 0. 000;χ2 = 96. 683,P = 0. 000,and the expre-ssion of SIRT-1 and NF-κB showed a positive correlation(r = 0. 480,P = 0. 001). There were significant posi-tive correlations between the expression of SIRT-1 and tumor size(r = 0. 227,P = 0. 018),TNM stage(r =0. 298,P = 0. 002)and lymph node metastasis(r = 0. 280,P = 0. 003),and there was negative correlation between the expression of SIRT-1 and differentiation(r = - 0. 300,P = 0. 002),and there were no correlation between the expression of SIRT-1 and sex,age and histological type in NSCLC tissues. There were significant positive correlation between the expression of NF-κB and TNM stage(r = 0. 256,P = 0. 009)and lymph node metastasis(r = 0. 261,P = 0. 006),and there was negative correlation between the expression of NF-κB and differentiation(r = - 0. 235,P = 0. 013),and there were no correlation between the expression of NF-κB and sex,age,histological type and tumor size in NSCLC tissues. Conclusion The positive expression rates of SIRT-1 and NF-κB in NSCLC tissue are significantly higher than those in normal lung tissue,and they are rela-ted to TNM stage,lymph node metastasis and differentiation,and the former is also related to tumor size. High expression of SIRT-1 and NF-κB may play important roles in the occurrence and development of NSCLC.

OBJECTIVE To explore the relationship between urinary tract infection(UTI) and urological surgical site infections(SSI).METHODS The surgical site infections of 115 patients underwent urological operations were observed.Patients were screened for the presence of UTI before the operation and subcutaneous swabs for culture were collected at the end of the operation by brushing with a sterile cotton-swab just before skin closure.The resistance and similarity of the isolates were analyzed by antimicrobial susceptibility test and pulsed field gel electrophoresis(PFGE).RESULTS Surgical site infection occurred in 14 of 115 patients.The isolates from infected surgical sites showed higher resistance to antimicrobial agents than those from non-infected surgical sites(P

Objective To examine whether microinjectlon of morphine into the rat thaiamle nucleus submedlus (Sin) could depress the bee venom (BV)-induced nociceptive behaviours. Methods In inflammatory pain model induced by BV subcutaneous injection into rat unilateral hind paw, the inhibitory effects of morphine microinjection into thalamic nucleus suhmedius (Sin) on the spontaneous nociecptlve behavior, heat hyperalgesia and tactile ailodynia, and the influence of naioxone on the morphine effects were observed in the rat. Results A single dose of morphine (5.0 μg, 0. 5μL) applied into the Sm ipsilaterni to the BV injected paw significantly depressed the spontaneous paw flinching response. Morphine also significantly increased the heat paw withdrawal iateneies in the bilateral hind paw and the tactile paw withdrawal threshold in the ipsilnteral hind paw 2 hours after BV injection. All these depressive effects could be effectively antagonized by pre-treatment with the opiuld receptor antagonist naloxone (1.0μg, 0. 5μL) in the Sm 5rain prior to morphine administration. Naloxone alone injected to the Sm had no effect on the BV-induecd nociceptive behavior. Conclusion These results suggest that Sm is involved in opioid receptor-mediated antt-nociception in the rat with the BV-induced inflammatory pain. Together with results from previous studies, it is likely that this effect is produced by activation of the Sm-ventrolateral orbital cortex-periaqueductal gray pathway, leading to activation of the brainstem descending inhibitory system and depression of the nodceptive inputs at the spinal cord level.

Thirty healthy women and 101 patients with polycystic ovary syndrome (PCOS) were recruited. According to serum testosterone (T) level and homeostasis model assessment for insulin resistance (HOMA-IR) ,the correlation of T and body mass index (BMI) with insulin resistance was analyzed. The results showed that there were 39. 8％ normal,24. 5％ overweight,and 35.7％ obese among 101 PCOS patients. However,there were no significantly differences in BMI, fasting plasma glucose ( FPG ), triglyceride ( TG ), total cholesterol ( TC), low-density lipoprotein-cholesterol ( LDL-C), high-density lipoprotein-cholesterol ( HDL-C ), and HOMA-IR levels between PCOS patients with hyperandrogenemia ( T ≥ 0. 51 μg/L) and normal androgenemia ( T ＜ 0. 51 μg/L). BMI, FPG, TG, TC, and LDL-C levels were higher and HDL-C level was lower in patients with insulin resistance( HOMA-IR ≥ 2. 29 ) than in patients without insulin resistance ( HOMA-IR ＜ 2. 29, P＜0. 05 or P＜ 0. 01 ). Serum T levels were not significantly different between two groups. HOMA-IR was significantly correlated with BMI(P＜0. 01 ), not with serum T, suggesting that the gain of body weight is correlated with insulin resistance independent of serum T level.

Objective To investigate the clinical and genetic characteristics in a patient with 17β-hydroxy-steroid dehydrogenase (17β-HSD) 3 deficiency, regarding its pathophysiology and pathogenesis. Methods Clinical features and laboratory data were analyzed in a pedigree of 17β-HSD3 deficiency. Blood samples from the patient and his parents were collected. HSD17B3 gene was screened for mutations by PCR and subclone sequencing. Results The patient presented with pubertal virilization and gynecomastia. The physical examination showed female external genitalia and testes in inguinal canals. The chromosome karyotype was 46, XY. Serum FSH, LH, dehydroepiandrosterone sulfate, androstenedione and 17-OH-progesterone levels were raised, whereas plasma testosterone was lowered. Sequencing analysis revealed 4 nucleotide deletion (172-175del) of HSD17B3 gene. Conclusion Virilization and gynecomastia in puberty suggest the probability of 17β-HSD deficiency. It may be verified clinically by hCG-stimulating test and confirmed by gene diagnosis.