Objective To explore the efficacy of closed reduction and inter na l fixation of cannulated screws by minimally invasive procedure in management of tibial plateau fractures. Methods From October 1999 to January 2002, 42 patient s with tibial plateau fractures, which were 29 males and 13 females with an aver age age of 41 years ranging from 26 to 67 years, were treated surgically in our hospital. According to Schatzker system, the fractures were diagnosed as type Ⅰ in 9, type Ⅱ in 5, type Ⅲ in 13, type Ⅳ in 3, type Ⅴ in 6 and type Ⅵ in 6. There was open fracture in 5, and closed fracture in 37. The fracture fragments of tibial plateau were reduced with closed manipulation or reduced assisted by minimally invasive procedure. The later by minimally invasive procedure included two kinds of reductions, one of which was reduction assisted by Kirschner pin t hat was introduced percutaneously into the larger fragment; the other was reduct ion assisted by a bone tamper that was introduced through a small incision into the cortical window beneath the depressed articular surface. Fixation was achiev ed using percutaneous 6.5 mm cannulated screws or combination of the cannulated screws and Bastiani external frame in unstable fractures. Results Of 42 patients , 37 were followed up from 6 to 30 months (average, 15 months). All 37 fractures were united within 12 weeks postoperatively. The mechanical axis of affected li mb and the stability of affected knee joint were restored in the patients. Accor ding to Sanders score for functional results of knee joint, 13 patients were rat ed as excellent, 20 good, and 4 fair. Anatomical reduction was identified while the stepping of articular surface after reduction was less than 2 mm. In 21 pati ents with anatomical reduction, the functional results were excellent in 8, good in 11, and fair in 2. However, in 16 patients without anatomical reduction, the functional results were excellent in 5, good in 9, and fair in 2. There was sig nificant difference between the two groups on functional results. There were no postoperative complications such as infections and neurovascular bundle. Conclus ion Closed reduction and fixation through minimally invasive procedure has provi ded satisfied results in tibial plateau fractures such as less complications, ex cellent mechanical axis restoration, and ideal functional recovery.

BACKGROUND: The inflammatory reaction occurs following implantation of cardiovascular stent with manifestations of the activation of blood coagulation system and dramatically increasing of inflammatory markers serum C-reactive protein. OBJECTIVE: To explore the changes of inflammatory reaction and C-reactive protein in coronary artery disease patients following cardiovascular stent implantation.METHODS: A computer-based online search of CNKI (1990/2009) and PubMed databases (1990/2009) was performed for related articles with the key words "cardiovascular stent, C-reactive protein" in Chinese and "cardiovascular stent on plasma, C-reactive protein" in English.RESULTS AND CONCLUSION: Based on the metal stents, drug-eluting stents can transfer the active drugs to the damaged vessels, release them into the vascular wall and inhibit the in-stent restenosis, Main drugs of anti-inflammatory drug-eluting stent include dexamethasone and methylprednisolone. Main drugs of anti-migratory and anti-proliferative drug-eluting stent includerapamycin, paclitaxel and actinomycin D. Main drugs of supporting intima concrescence stent include estradiol. Coronary artery stents implantation can induce and aggravate local inflammation reaction, which have important infection for vascular endodermis hyperplasia and restenosis occurrence. Some impressible index for inflammation reaction, such as levels of C-reactive protein,have predictive value for vascular events following the coronary artery stents implantation. A significant increase in plasma C-reactive protein after coronary stenting has been observed following stent implantation. Therefore, understanding of inflammatory reaction and C-reactive protein, as well as cytokine changes is important for preventing restenosis, early treatment of restenosis, as well as improving treatment effect.

Through analysis of the anatomic and physiological characteristics and the pathophysiological changes of 84 obstructive sleep apnea syndrome (OSAS) patients,the risks and key points of nursing care during general anesthesia were summarized,such as careful assessment of the patient situation,preparations of first aid materials and drugs,close observation and cooperation with the procedure of anesthesia,timely detecting and dealing with the abnormal changes during anesthesia.

10.3969/j.issn.2095-4344.2013.23.005

BACKGROUND: Intramyocardial transplantation of autologous umbilical cord-derived mesenchymal stem cells for repair of myocardial tissue damage is paid increasing attention in the cardiovascular field. OBJECTIVE: Human umbilical cord mesenchymal stem cells were isolated and cultured. Passage 2 human umbilical cord mesenchymal stem cells were treated with various concentratins of 5-azacytidine (2.5, 5, 10, 20, 40, 80 μmol/L) for 24 hours . After removal of 5-azacytidine, cells were cultured for another 4 weeks. RESULTS AND CONCLUSION: Before 5-azacytidine treatment, filament-like structures or particles were not observed in the cells, but the amount of cytoplasm was less and uniform, nuclear/cytoplasm ratio was high, cells exhibited typical fusiform appearance and grew in a swirl-like manner, and nucleolus was obvious. After treatment with 5-azacytidine for 24 hours, some cells died in each group, and typical fusiform appearance turned into stick-like or column-like appearance, especial y in the 40 and 80 μmol/L 5-azacytidine groups. Reverse transcription-PCR results showed that atrial natriuretic peptide and α-skeletal actin gene expression levels were detected on human umbilical cord mesenchymal stem cells after treatment with 2.5 or 40 μmol/L 5-azacytidine for 4 weeks or with 5, 10, 20 μmol/L 5-azacytidine for 1, 2, 3 and 4 weeks. These findings suggest that 5-azacytidine-induced human umbilical cord mesenchymal stem cells express the specific gene of myocardiocytes.

Objective To explore the attentional biases in individuals with different types of obsessivecompulsive symptom and the correlations between the attentional bias of high obsessive compulsive symptom (HOC) and symptoms. Methods 22 individuals with HOC and 38 individuals with low obsessive compulsive (LOC) symptom completed the Chinese Emotional Stroop task that assessed the attentional bias. Comparisons were made between HOC and LOC and in different types of HOC, and the correlations between the attentional bias of HOC and symptom severity scores were searched for. Results The comparison between HOC and LOC on the reaction time of neutral, negative and disgust-related words were not significant. The contamination/washing subtype in HOC showed faster reaction time on negative and disgust-related words compared to that of neutral words,and its attentional bias exhibited significant correlation with symptom severity scores( r= -0. 648, P=0. 031 ). Conclusion Such information point out the contamination/washing subtype may have a different neural mechanism compared to the other subtypes of OCD.

Objective To explore the characteristic and clinical meaning of myocardial bridge in patients with multi-slice spiral CT(MSCT) coronary angiography.Methods 875 patients with suspected or diagnosed coronary artery disease were studied with MSCT coronary angiography,579 cases were male and 296 cases were female,ranged from 30~87 years old in age with average of 60 years old.The heart was scanned with retrospectively ECG-gated,reconstruction from phase for all original tomographic source images at 30%~40% R-R phase interval according to heart rate ≥75 bpm and at 40%~50% R-R phase interval according to heart rate ≤75 bpm.The images of maximum intensity projection,multiplanar reconstruction and vulume reconstruction were gained to show left and right main coronary artery and their main branchs on mulliple angle.Results The myocardial bridges were detected in 89 cases,the positive rate was 10.2%,36 cases(40.5%)had different grade stenosis(≤50%).The myocardial bridges located at middle segment of anterior descending artery(79.8%),the thickness of myocardial bridge was 0.06~0.55 cm,the atherosclerosis plaques were found in 20 cases,the vascular stenosis was approximate to 50%.39 cases with simple myocardial bridges had angina,21 cases hadn’t angina.23 cases with myocardial bridges accompanied by coronary artery atherosclerosis had angina.Conclusion MSCT coronary angiography may clearly detect the myocardial bridge,which can provide more worthy information for clinical diagnosis and treatment.

Objective To observe the clinical efficacy of electroacupuncture plus nasal irrigation in treating upper airway cough syndrome (UACS).Method A total of 114 UACS patients were randomized into 3 groups, 38 cases in each group. Group A was treated with acupuncture plus electrical stimulation with sparse-dense wave, group B was intervened by nasal irrigation with Shuang Huang Lian, and group C was treated with the two methods together. The clinical efficacies of the three groups were compared.Result The total effective rates were respectively 84.2%, 73.7% and 94.7% in group A, group B and group C. The total effective rate of group C was significantly different from that of group A and group B (P<0.05).Conclusion Electroacupuncture plus nasal irrigation can produce a more significant therapeutic efficacy compared to electroacupuncture or nasal irrigation alone.

Objective To develop a lower limbs rehabilitative apparatus and explore its effects. Methods From January to September, 2016, 28 children with spastic cerebral palsy were divided into control group (n=14) and observation group (n=14) randomly. The control group received routine rehabilitation, while the observation group received self-made lower limbs rehabilitative apparatus training addition-ally. They were assessed with Gross Motor Function Measure (GMFM)-88 and Berg Balance Scale (BBS) before and three months after treatment. Results There was no significant difference in the scores of GMFM-88 and BBS between two groups before treatment (P>0.05), while they increased after treatment (t>6.124, P<0.001), and were higher in the observation group than in the control group (t>2.329, P<0.05). Conclusion Self-made lower limbs rehabilitative apparatus could help to improve the gross motor function and balance function in children with spastic cerebral palsy.

The biochemical study of the nutritional status of 101 healthy pregnant women and cord blood samples showed that maternal serum protein, albumin, hemoglobin (Hb), iron (Fe), zinc (Zn) and calcium (Ca) were decreased, and serum transferrin and copper (Cu) were increased in the course of gestation.Correlation coefficients and stepwise regression analysis suggested that the concentrations of serum protein, Fe, Zn, Ca,Hb were positively correlated with the intake of calories, proteins, animal foods (especially fish and meats), Ca and vitamin C.The concentration of cord blood Ca,Zn and Fe were found highly related to the maternal serum levels in the late stage of pregnancy (P