[Objective]To investigate the biomechanical effect of mid-upper fibular fracture on ankle joint.[Method]From January 2005 to June 2006,20 cases of mid-upper fibular fracture were collected.Normal anterior film of bilateral ankle joint was photographed,ankle mortise width and distal fibula upper shift were measured to observe the effect on stability of ankle joint.Foot-scan pressure analyzer was used to detect the central track of footplate pressue,subtalar joint angle,in order to compare the difference between normal ankle and the sick.[Result]Dislocated mid-upper fibular fracture could lead to ankle mortise widening,lateral malleolus up shift ( averaged,1.260?0.339mm,1.045?0.276mm).the central track of footplate pressure offset and the fracture sides subtalar joint angle were larger than those in normal feet(P

Objective: To study the influence of micrometastasis in lymph node on the prognosis of oral squamous cell carcinoma(OSCC).Methods: In 36 patients micrometastasis in pathologically negative lymph nodes were tested by immunohistochemical cytokeratin(CK) examination and the relationship between CK+ and survival time of the patients was analyzed. Results: The survival time(month) of CK+ and CK- patients was 36.76?6.91 and 47.47?11.35 respectively(P=0.002).Multivariate analysis of Logistic regression model showed that micrometastasis in lymph node (P=0.044)and histologic grade (P=0.040) were regarded as independently prognostic factors while clinical stage (P=0.236)did not. Conclusion: The detection of micrometastasis in the lymph nodes may serve as a supplement to the present staging system of OSCC. The prognosis of patients with micrometastasis is poorer than those without micrometastasis.

Objective To investigate the effects of Huangkui Capsules on oxidative stress and micro-inflammation state in diabetic nephropathy patients with maintenance hemodialysis. Methods Forty-six patients with diabetic nephropathy who had received maintenance hemodialysis for over six month in Gansu Provincial People's Hospital were randomly divided into observation group (23 cases) and treatment group (23 cases) from January to December in 2014. Twenty healthy subjects who had physical examinations were selected as the control group at the same time. Observation group were given conventional hemodialysis for 4 hours, 3 times a week; treatment group were given conventional hemodialysis combined with Huangkui Capsules, orally, 2.5 g each time, 3 times a day. Both groups were treated for 8 weeks. Blood was collected before and after treatment for detection of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), white blood cell (WBC), malondialdehyde (MDA), cycle of advanced oxidation protein products (AOPP), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels. Results The levels of IL-6, TNF-α, AOPP, WBC, MDA and hs-CRP were significantly higher in the observation group and the treatment group compared with the control group before treatment (P<0.01), SOD and GSH-Px levels decreased (P<0.01); there was no statistical significance between the observation group and the treatment group (P>0.05). After treatment, the levels of IL-6, hs-CRP, MDA and AOPP increased in the observation group (P<0.05), GSH-Px and SOD decreased (P<0.05), there were no statistical significance in TNF-αand WBC (P>0.05);The levels of AOPP, TNF-α, hs-CRP, WBC, MDA and IL-6 in treatment group significantly decreased (P<0.01), GSH-Px and SOD significantly increased (P<0.01); there was statistical significance between the observation group and the treatment group (P<0.01). Conclusion Micro-inflammation state and oxidative stress exist generally in diabetic nephropathy maintenance hemodialysis patients. Huangkui Capsules can improve oxidative stress and micro-inflammation state in diabetic nephropathy maintenance hemodialysis patients.

0.05). Conclusion\ The hemodynamic factors and the mean vascular wall shear stress were useful parameters for the evaluation of the effect of vascular repair. Periodical and continuous observations are helpful for predicting the outcome of vascular anastomosis repair.

Objective To determine the prediction and clinical characteristics of intravenous immunoglobulin (IVIG) treated Kawasaki disease (KD) failure in initial dose.Methods Retrospective analysis was performed with the clinical data of 1 11 children with KD.The paticnts were divided into sensitive group and unresponsive group according to initial effect of IVIG.The clinical manifestations,laboratory examination and radiological features of the children were compared.Logistic regression analysis was performed in significant different indicators to determine independent correlation factors.In order to seek the reference indexes which indicate unresponsive to IVIG,a receiver operating characteristic (ROC) curve was made,of which the diagnostic cut-off was nine independent correlation factors while grouping was made according to patients' different responses to IVIG.Results (1)There were 90 cases (81.1％)in effective group and 21 cases (18.9％) in unresponsive group.(2) Compared with the sensitive group,hyperpyrexia cases[66.7％ (14/ 21 cases) vs 34.4％ (31/90 cases),x2 =7.334,P =0.007] and the chances of coronary artery lesions [47.6％ (10/ 21 cases) vs 23.3％ (21/90 cases),x2 =4.989,P =0.026] were significantly higher in the unresponsive group.(3)Compared with the children administered twice with gamma globulin,the children of single-dose treatment significantly reduced the unresponsive probability [12.5 ％ (9/72 cases) vs 30.8 ％ (12/39 cases),x2 =5.504,P =0.019],and there was no difference in the chances of coronary artery lesions[23.6％ (17/72 cases) vs 30.8％ (12/39 cases),x2 =0.672,P =0.412].(4)Comparing the sensitive group and the unresponsive group,the percentage of neutrophils count [(0.72 ± 0.06) vs (0.76 ± 0.04),t =-2.84,P =0.005],platelet counts [(352.38 ± 42.18) × 109/L vs (373.14 ±36.93) × 109/L,t =-2.076,P =0.040] and C-reactive protein (CRP) [(74.38 ± 12.92) mg/L vs (92.05 ± 11.17) mg/L,t =-5.780,P =0.000] were significantly higher in the unresponsive group,but the level of serum albumin[(34.09 ±3.19) g/L vs (31.61 ±2.03) g/L,t =4.442,P =0.000] was lower.(5) Multivariate Logistic regression analysis indicated that the percentage increase of neutrophils count (P =0.018),CRP (P =0.000) increase and serum albumin(P =0.040) decrease were independent risk factors for unresponsive treatment with gamma globulin.(6)After the area under the ROC curve was calculated,the percentage of neutrophils count,CRP and serum albumin could be effective predictors to IVIG treatment failure in initial dose,and the critical values were 0.72,78.5 mg/L and 33.11 g/L,respectively.Conclusions Treatment with IVIG for the first time may be ineffective in some situations such as the percentage of neutrophils count ≥0.72,CRP ≥78.5 mg/L or serum albumin≤33.11 g/L.

Objective To evaluate the clinical effect of different oral care solution.Methods Literature data were collected by computer retrieval covering China National Knowledge Infrastructure (CNKI),China Biology Medicine (CBI) and Wanfang database,and Note Express and Addis software were used to evaluate the randomized controlled trials of literature.Results 19 separate randomized controlled trials were included in the research hterature;Network Meta analysis results showed that in the prevention of ventilator-associated pneumonia,the electrolyzed oxidizing water,compound chlothexidine,hydrogen peroxide,sodium bicarbonate,distilled water and 0.9％ saline had statistically significant difference (OR=0.25,95％CI=0.02-0.72),and the effect of sodium bicarbonate was better than the other oral care solutions;in the prevention of oral odor,the oral care solution had no significant difference (OR=0.86,95％CI=0.34-1.74),and sodium bicarbonate of the total ranked the best preventive effect;in the prevention of oral infection,the oral care solution had no significant difference (OR=0.62,95％CI=0.09-1.60).Conclusions Based on the meta analysis results,with 0.9％ saline for common interventions,sodium bicarbonate oral nursing liquid is superior to other oral nursing liquid in the prevention of ventilator-associated pneumonia,oral smell and infection.

ObjectiveTo evaluate the efficacy and safety of Qingpeng ointment in the treatment of chronic eczema.MethodsTotally,95 patients with chronic eczema were enrolled and divided into 3 groups to receive topical Qingpeng ointment (n =33),0.2％ hydrocortisone cream (n =32),10％ urea ointment (n =30) respectively twice a day for 4 weeks.All the patients were followed up once a week for the evaluation of therapeutic and side effects.ResultsAfter 4-week treatment,the response rate was 78.8％,84.4％ and 46.7％ in the Qingpeng ointment-,hydrocortisone cream- and urea ointment-treated patients respectively.Significant differences were observed in the response rate between the Qingpeng ointment- and urea ointment-treated patients (P ＜ 0.05 ),but not between the hydrocortisone cream- and Qingpeng ointment-treated patients (P ＞0.05).Skin flushing with a sensation of burning was observed at the application sites of 2 patients treated with Qingpeng ointment,and tingling sensation at the application sites was reported in 1 patient treated with hydrocortisone cream.All of these adverse reactions were tolerable and had no influence on the treatment.Conclusion Topical Qingpeng ointment is effective and safe for the treatment of chronic eczema.

BACKGROUND: Previous experiments have shown that transforming growth factor-?1 (TGF-?1),matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1) play an important role in chronic allograft nephropathy,but the mechanisms remains unclear. OBJECTIVE: To investigate the expression and significance of TGF-?1,MMP-2 and TIMP-1 in the renal tissues of chronic allograft nephropathy and normal renal tissues. DESIGN,TIME AND SETTING: A histological and morphological control observational experiment of cytology was performed at Pathological Laboratory of the 175th hospital from June to October 2008. PARTICIPANTS: The transplanted renal tissues extracted from 24 patients with chronic allograft nephropathy were used in the experiment,and the normal renal tissues in 10 patients were assigned as controls. METHODS: Immunohistochemical staining was performed in all the renal tissues. All the renal tissues were fixed with formaldehyde and embedded by paraffin wax. Then the sections were prepared with a thickness of 3 ?m,and were then closed with normal non-immune serum. Subsequently,the sections were incubated as follows: primary antibody,secondary antibody,streptavidin peroxidase complex,and diaminobenzidine (DAB),followed by HE counterstaining. The sections were cleared and coverslipped. MAIN OUTCOME MEASURES: The expressions of TGF-?1,MMP-2 and TIMP-1 in the renal tissues were observed by immunohistochemical staining. The relationships among TGF-?1,MMP-2 and TIMP-1,as well as between them and the grade of chronic allograft nephropathy were analyzed. RESULTS: Qualitative analysis: The TGF-?1,MMP-2 and TIMP-1 showed strongly positive expressions in the cytoplasm and membrane of renal tubular epithelial cells in transplanted renal tissues. Quantitative analysis: There were significant differences in expression of TGF-?1,MMP-2 and TIMP-1 between in transplanted renal tissues and in normal renal tissues (P

Objective To study the effects of musk on the expressions of fibroblast growth factor 2 (FGF-2) and epidermal growth factor (EGF) in the rat model of skull bone defect.Methods We constructed the bone defect model by dental drilling into the full skull of 300 SD rats (150 males and 150 females).The model animals were divided with completely random method into model group and drug group,with 150 in each.The two groups were further divided according to drug administration time into 7,14 and 28 d groups,respectively,with 50 in each.The drug group received perfusion of natural musk every day (4.2 mg/100 g) while the model group received perfusion of normal saline of the same volume every day.FGF-2 mRNA and EGF mRNA expressions in skull bone defect were determined using Real-time fluorescent quantitative PCR method.Results EGF mRNA expression at 7 d and 14 d was higher in the drug group than in the model group,but with no significant difference.EGF mRNA expression at 28 d decreased to the lowest level,with a significant difference (P＜0.05).FGF-2 mRNA expression in the drug group reached the highest at 7 d,with a significant difference (P＜0.05),and decreased at 14 and 28 d without significant difference.Conclusion Musk administered at different time points can effectively promote the healing rate of the bone defect area of the rat skull,and the mechanism of this repair is mainly related to the increased FGF-2 mRNA expression and the decreased EGF mRNA expression.

Long bone osteomyelitis often results from serious open fractures or some closed fractures.Its treatment is a clinical difficultly in orthopaedics.Masquelet is a new strategy for bone reconstruction,validated by surgeons in their treatment of acute bone loss,bone tumor and bone infection.It is carried out in 2 stages.At the first stage,infection was eliminated by radical debridement and placement of antibiotic bone cement into the defect,which induces a pseudomembrane to facilitate the growth of bone graft.At the second stage,reconstruction of the bone defect is performed by bone grafting in the membrance after removal of the bone cement.The unique characteristics of this technique arouse more and more attention recently.Therefore,we would like to present a review about this Masquelet technique dealing with post-traumatic osteomyelitis of long bones.