Objective To estimate the effect of open reduction and internal fixation for treating the trimalleolar fracture in the elderly.Methods 57 aged patients suffered from the trimalleolar fracture and were treated with internal fixation from January 2009 to June 2012.25 males and 32 females with an average age of 71.5 years ranged from 65 to 81 years were involved in this study.The supination-external rotation type were in 41 cases and pronation-external rotation type in 16 cases according to Lauge-hansen's classification.The posterior and lateral approach was taken for surgical procedure of lateral malleolar frature.The routine or locking plates were used to fix the fratures.The posterior malleolar fractures were usually fixed through the posterolateral approach as well.The screws or tension band fixation was selected for fixing the medial malleolar fragments.The parallel screwing fixation could be helpful for fixing the tibiofibular syndesmosis.Results The ankle function was evaluated by the criteria system of the American Orthopaedic Foot and Ankle Society (AOFAS).The efficacy was excellent in 23 patients,good in 24 patients,fair in 7 patients.The skin problems such as super facial infection and delayed union of incision were in 7 cases.Conclusions If choosing reasonable operation method and suitable internal plant,the open reduction and internal fixation has better effect in treating the trimalleolar fracture in the elderly,with fewer complications.

ObjectiveTo understand the clinical and microbiological characteristics of AIDS-associated bloodstream infection (BSI).MethodsThe clinical and laboratory ifndings of 143 cases of BSI in AIDS patients who were hospitalized during the period from 2013 to 2014 were retrospectively analyzed.ResultsThe prevalence of BSI in AIDS patients was 22.1%. The 143 patients were divided into two groups in terms of fungal or bacterial infection. The incidence of speciifc skin rashes, anemia, hepatosplenomegaly and lymph node enlargement in fungal infection group was higher than those in bacterial infection group (allP<0.05). CD4+ cell count, WBC, neutrophils, RBC, hemoglobin, and platelet count in fungal infection group were lower than those in bacterial infection group, while AST and Cr were the opposite (allP<0.05).Penicillium marneffei(84/143, 58.7%) was the most common pathogen isolated from AIDS-associated BSI, followed byEscherichia coli (10/143, 7.0%),Cryptococcus neoformans (9/143, 6.3%),Klebsiella pneumoniae (7/143, 4.9%),Salmonella (6/143, 4.2%),Candida albicans(3/143, 2.1%), andAeromonas (3/143, 2.1%). Most strains were still susceptible to the commonly used antibiotics.ConclusionsThe prevalence of BSI is high in AIDS patients. Fungal BSI is more likely to have skin rash, anemia, hepatosplenomegaly and lymphadenopathy, hematologic abnormalities, liver and renal function impairment. Fungi, especiallyPenicillium marneffei, are the main pathogen of AIDS-associated BSI. Most strains are susceptible to the commonly used antibiotics.

OBJECTIVE: To assess the evaluation on auditory rehabilitation effect for 42 deaf children with GJB2 gene mutation after cochlear implantation to provide a reference for the cochlear implant effect evaluation of such patients. METHOD: To conduct the detection on common genetic deafness gene mutation hotspots of hearing impaired children with cochlear implantation. To conduct auditory rehabilitation effect evaluation on 42 cases of patients with GJB2 genetic deafness after 3 months, 6 months and 12 months of the operation respectively. The single factor repeated measure ANOVA was applied to analyze whether there were significant difference among the results of initial consonant of a Chinese syllable recognition at 3 different stages after the operation, the results of vowel of a Chinese syllable recognition at 3 different stages after the operation, and the results of two-syllable recognition at 3 different stages after the operation. RESULT: 235delC is the high-incidence mutational site in 42 cases of patients with GJB2 genetic deafness, the total detection rate is up to 90.48%. There were significant differences in the initial consonant of a Chinese syllable recognition rate, the vowel of a Chinese syllable recognition rate, the two-syllable recognition rate as well as the vowel of a Chinese syllable recognition rate after 3 months, 6 months and 12 months of the operation (P < 0.01). CONCLUSION Cochlear implantation is a safe and effective measure for auditory reconstruction, it can help patients with GJB2 hereditary severe sensorineural deafness to improve auditory speech recognition.
Asian Continental Ancestry Group ; Child ; Cochlear Implantation ; Connexin 26 ; Connexins ; genetics ; Deafness ; genetics ; rehabilitation ; Hearing Loss, Sensorineural ; genetics ; rehabilitation ; Humans ; Language ; Mutation

OBJECTIVE:To compare the clinical efficacy and safety of Kangshuling gel,mupirocin and lactate ethacridine in the treatment of diabetic foot. METHODS:90 patients with diabetic foot were randomly divided into Kangshuling group,mupiro-cin group and lactate ethacridine group. All the patients were treated by lowing blood glucose,nutritional support,improving micro-circulation and anti-infection,etc. On this basis,3 groups were given Kangshuling gel,Mupirocin ointment and Lactate ethacridine solution for wet compress by gauze. The course was 180 d. The clinic data was observed,including clinical efficacy,and wound ar-ea,healed patients’granulation,epithelial tissue,healing time and incidence of adverse reactions before and after treatment. RE-SULTS:The total effective rate in Kangshuling group was significantly higher than mupirocin group and lactate ethacridine group;healed patients’granulation,epithelial tissue and healing time were significantly shorter than mupirocin group and lactate ethacri-dine group,with significant differences(P<0.05). After treatment,wound area in each group were significantly smaller than be-fore,and Kangshuling group was smaller than mupirocin group and lactate ethacridine group,with significant differences(P<0.05);there were no significant differences between mupirocin group and lactate ethacridine group(P>0.05). There were no obvi-ous adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,Kangshuling gel has better efficacy than mupirocin and lactate ethacridine in the treatment of diabetic foot,with good safety.

OBJECTIVE:To explore the clinical features and regularity of drug-induced liver injury (DILI),and to provide reference for clinical rational drug use. METHODS:104 DILI cases in our hospital from 2005 to 2014 were selected and analyzed retrospectively in respects of patient’s gender,age,allergic history,medication history,drug type and clinical manifestations. RE-SULTS:DILI hospitalized cases increased year by year. There were 47 males and 57 females,and average age was(8.71±13.90). The clinical symptoms appeared within 12 weeks after using the drug. The symptoms were no specific,including weak,anorexia, jaundice,yellow urine,etc. and 10.57% of patients were asymptomatic. Most of the DILI cases were hepatocyte type(80.77%), followed by cholestasis type(12.50%)and hybrid type(6.73%). The most common cause of drug-induced liver injury were TCM, antimicrobial drugs and the nervous system drugs. CONCLUSIONS:The incidence of DILI in females is slightly higher than males. DILI often occurs after 40 years old. The clinical symptoms have no specificity and are similar to viral hepatitis. The hepatic lesions can be caused by most of drugs. DILI by TCM should concerned. Clinical physicians should pay more attention to DILI.

Objective To explore the application of single-person operated mammotome minimally inva-sive surgery in treatment of benign breast lesions. Methods Clinical information of 403 patients were collected and retrospectively analyzed. 262 patients receiving ultrasound guided single-person operated mammotome mini-mally invasive surgery for benign breast masses were selected as the treatment group,141 patients undergoing open surgery for treatment of benign breast masses were selected as the control group.Operative time, introopera-tive blood loss,length of stay,postoperative healing time, as well as the occurrence of complications were com-pared between the two groups. Result Compared with the control group, the operative time was shorter, the in traoperative blood loss was less, the scar size and the postoperative healing time were shorter for the treatment group. The difference had statistical significance (P<0.05).The rate of postoperative pain, local ecchymosis, local infection and breast deformity for the treatment group was significantly lower than those of the control group (P<0.05). The difference had statistical significance (P<0.05). The recurrence rate between the two groups had no sta-tistical significance (P>0.05). Conclusions Single-person operated Mammotome minimally invasive surgery has the advantages of good operative time,good cosmetic effects, small surgical trauma, less blood loss, fast postoper-ative healing and few complications, which is worthy of clinical application.

BACKGROUND:Inflammation plays an important role in vessel proliferation after balloon injury.Reducing inflammatory reaction may lighten the ocurrence and development of the restenosis after angioplasty.Studies have demonstrated that PPAR? excitomotor has inhibitory effects on inflammation development.OBJECTIVE:To observe the changes in inflammatory factors after carotid artery balloon injury in rats and the intervention of PPAR? excitomotor rosiglitazone.DESIGN,TIME AND SETTING:The randomized,controlled animal experiment was performed at the Central Laboratory of Shenzhen People's Hospital from January to June 2009.MATERIALS:Male SPF SD rats weighing about 350 g were selected to generate models of carotid balloon injury.METHODS:SD rats were equally and randomly divided into 3 groups:the control group,the balloon injury group and the rosiglitazone group.The left common carotid arteries were injured by balloon in the balloon injury group and the rosiglitazone group.The control group received sham operation.The rosiglitazone group was administered rosiglitazone daily by gavage,which began 4 days before operation and continued until harvesting.Accordingly,the control group and the balloon injury group were administered normal saline daily by gavage.MAIN OUTCOME MEASURES:All rats were executed under anesthesia at 14 days after operation,respectively to harvest left common carotid artery samples.The vessels were stained by hematoxylin-eosin,and Neointimal area(NIA) and media area(MA) as well as NIA/MA were calculated.Real time RT-PCR and Western Blot method were used to assay the expression of interleukin(IL)-6,IL-10,IL-17A mRNA and the distribution of nuclear factor(NF)-?B protein.RESULTS:Of the 36 rats,5 were excluded due to failed modeling or death,and 31 rats were included in final analysis.①The expression levels of IL-6 and IL-17A mRNA in the rosiglitazone group were significantly lower than the balloon injury group,but higher than the control group(P

Objective To investigate the changes of serum diamine oxidase(DAO) levels in patients with severe acute pancreatitis(SAP) and their relationship with computed tomography severity index(CTSI) score and gastrointestinal dysfunction.Methods A total of 60 SAP patients were recruited into group SAP,the other 40 healthy people were recruited into control group,DAO,lactic acid,tumor necrosis factor-α(TNF-α),intestinal trilobites factor(ITF),cream ball epidermal growth factor 8(MFG-E8) were compared in the two groups.Results DAO,lactic acid,TNF-α in SAP group with onset within 72 hours were(3.09±1.33)U/mL,(928.50±69.37)ng/mL and (269.41±31.85)pg/mL,which were significantly higher than(1.20±0.58)U/mL,(311.64±38.25)ng/mL and (38.24 ± 3.03)pg/mL in the control group,the differences were statistical significant(P<0.05).The serum levels of ITF,MFG-E8 in SAP group were(3.60±0.35)ng/mL,(81.49±27.32)pg/mL,which were significant lower than(4.39±0.26)ng/mL,(234.17±49.08)pg/mL in the control group,the differences were statistical significant(P<0.05).In the SAP group,the serum levels of DAO showed significant positive correlations with D-lactate,TNF-α levels,CTSI score,APACHEⅡ score,gastrointestinal dysfunction score(P<0.05),but had significant negative correlation with ITF,MFG-E8(P<0.05).Conclusion Serum DAO level evaluated significantly in patients with SAP,and closely related to the severity of the disease and the dysfunction of the gastrointestinal tract.

Objective To study the expression pattern of RYK in the pathway of developmental corticospinal tract projection and provide hints for further study on RYK's function involved in this processes.Methods By In situ and immuno-fluorescence histochemistry,we examined the RYK expression pattern in the developmental murine motor cortex and the projection of corticospinal tract at various time points of E14.5、 E16、E18.5 and postnatal P3、 P5、P7.Results The motor cortex the RYK expression started at E18.5 stage and enhanced gradually at P0 stage.Moreover from P0 to P5 stage the RYK expression also appeared in the pathway of developmental corticospinal tract and decreased gradually after that.Conclusion RYK's expression is closely related to the corticospinal tract projection during its development stage.

ATP(adenosine 5′-triphophate)is a kind of purine involved in neural transmission and regulation.With the in-depth studying about purine and pyrimidine receptor subfamilies,ATP and its receptor will become a variety of potential drug targets of disease control.The application of resonance energy transfer technology,systematic evolution of ligands by exponential enrichment in vitro and small interfering RNA technology in vivo not only expand the perspective of purinergic signaling research,but also promote their progress in disease prevention and drug screening.