[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

AbstractBACKGROUND: Fas and P53 are important regulator and control gene which can promote apoptosis. They belong to the receptor family part of tumor necrotic factor/nerve growth factor. Their expression products have effects on apoptosis signal transmission, and can regulate and control cell apoptosis in cerebral ischemia-reperfusion injury. And puerarin can alleviate the level of cell apoptosis.OBJECTIVE: To observe the effect of puerarin on Fas and P53, the apoptosis-related gene of nerve cell in hippocampns CA1 region of rats af ter cerebral resuscitation.DESIGN: Randomized controlled trial. SETTING: Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. MATERIALS: The experiment was carried out at Emergency Department, Tongji Hospital, Tongji Medical College, Huazhong University ofScience and Technology from September 2001 to Februray 2002. Totally 45 of 3 months old Wistar rats of clean grade were selected, and randomly divided into 3 groups: sham operation group, model control group and puerarin treatment group with 15 rats in each group.METHODS: Acute global brain ischemia-reperfusion models were established in rats of puerarin treatment group and model control group. In rats of sham operation group, stigmata of both flanks of the first cervical vertebrae were isolated, but bilateral vertebral arteries were not electric coagulated, and biolateral common carotid arteries were only isolatedwithout clamping close. Rats in puerarin treatment group were given puerarin injection 100 mg/kg, 1 hour before ischemia, and model control group were given normal saline in equivalence while rats in sham operation group were not given medicine. Death of rats in each group was performed separately in the 3rd, 6th, 12th, 24th and 48th hours after cerebral ischemia-reperfusion with 3 rats per group in each time. Hippocampus tissues of rats were isolated, and tissue slices were preparated. And the changes of- the protein expression levels and the number of apoptosis cells of rats in each group at different time point after cerebral ischemia-reperfusion were detected in immuno-histochemical method and end labelling in situ method. MAIN OUTCOME MEASURES: ① The number of positive cells inprotein expression of Fas and P53 in hippocampus CA1 region of rats in each group at different time point after cerebral ischemia-reperfusion was studied. ② Comparison of the number of apoptosis cells in hippocampus CA1 region of rats between groups at different time point after cerebral ischemia-reperfusion were studied, too.RESULTS: All the 45 rats enrolled in research were entered the stage of result analysis: ① The number of positive cells in protein expression of Fas in hippocampus CA1 region of rats in each group at different time point after cerebral ischemia-reperfusion: Obvious gene expression of Fas was not found in sham operation group. In contrast with model control group, obvious decrease was found at all time points after cerebral ischemi a-reperfusion in puerarin treatment group, and in the 6th, 12th, 24th and 48th hour the differences were significant [(15.0±4.3), (13.5±4.9); (40.7±3.4), (27.2±3.1); (37.0±4.8), (22.0±2.1); (24.7±4.1), (18.9±5.3)/mm; P < 0.05,P < 0.01]. ② The number of positive cells in protein expression of P53 in hippocanpus CA1 region of rats in each group at different time point after cerebral ischemia-reperfusion: Obvious gene expression of P53 was not found in sham operation group. In contrast with model control group, obvious decrease was found in the 24th and 48th hour after cerebral ischemiareperfusion in puerarin treatment group [(25.3±4.4), (12.8±2.7); (24.3±3.6), (10.9±3.0)/mm; P < 0.01]. ③ Comparison of the number of apoptosis cells in hippocampus CA1 region of rats between groups at different time point after cerebral ischemia-reperfusion :In contrast with model control group,obvious decrease was found in the 12th, 24th and 48th hour after cerebral is chemia-reperfusion in puerarin treatment group [(34.0±3.7), (21.0±3.7); (41.0±4.2), (33.0±4.8); (71.0±5.5), (41.0±3.4)/mm; P < 0.01].CONCLUSION: In rats which were given puerarin treatment, the expression of Fas decrease obviously in 6 to 48 hours after cerebral ischemiareperfusion, and the expression of P53 decreased obviously in the 24th to 48th hour after cerebral ischemia-reperfusion, and a descent tendency could be found in the number of apoptosis cells. These can further prove the cerebral protective effect of puerarin, and indicate that the inhibition of puerarin to cell apotosis after cerebral resuscitation is related to its effect on the decrease in protein expression of apoptosis-promoting gene, Fas and P53.Puerarin has a protective effect on cerebral ischemia-reperfusion injury of rats. In comparison with model control group, the expression of Fas in puerarin treatment group has an obvious decrease inthe 6th to 48th hour after cerebral ischemia-reperfusion, the expression of P53 has an obvious decrease in the 24th to 48th hour after cerebral ischemia-reperfusion, and the number of apoptosis cells decrease obviously, too, which further improves the cerebral protective effect of puerarin and indicates that the inhibition of puerarin to cell apoptosis after cerebral resuscitation is related to its effect on the decrease in protein expression of apoptosis-promoting gene Fas and P53.

Objective:To establish a precise three-dimensional finite element model of temporomandibular joint.Methods: On the basis of images of Chinese Visible Human, the reverse engineering technology was applied to reconstruct the Computer Aided Design(CAD) model of temporomandibular joint.Afterwards, the model was established. Results:A three-dimensional finite element model consisting of 66 122 nodes and 212 704 elements of temporomandibular joint including cortical bone, cancellous bone, mandibular dental arch, masticatory muscles, articular cartilage and periodontal ligament was constructed. Conclusion:The finite element model is more efficient and more precise.

Objective To study the difference between the metabolic syndrome(MS)diagnosis made with International Diabetes Federation(IDF)worldwide definition and the Adult Treatment Panel Ⅲ (ATPⅢ)of National Cholesterol Education Program(NCEP).Methods Cross-sectional study and descriptive study were used.Results There were 1328 MS patients diagnosed with IDF and 1527 MS patients diagnosed with ATPⅢ.There were 199 MS patients diagnosed with ATPⅢbut not with IDF and these MS patients all had 3-4 risk factors.According to the abnormality of glucose.blood pressure and lipid regulation stated in ATPⅢ criteria.759 more patients were diagnosed as MS than with IDF criteria.Conclusions MS diagnosed with ATP Ⅲ criteria iS more objective than with IDF criteria and ATPⅢ criteria has more space for further theoretical study.

Objective To establish the quality standard of Fengshi Bitong Capsule.Methods Notopterygh Rhizoma,Angelicae Pubescentis,and Saposhnikoviae Radix were identified by thin layer chromatography(TLC).Aconitine limit test in this drug also carried out by TLC.The contents of Isoimperatorin in the Notopterygh Rhizoma were determined by high performance liquid chromatography(HPLC).Results The spots in the TLC were fairly clear and no interference was shown in the blank samples.The aconitine limited in conformity with the 《Chinese Pharmacopoeia》 2010.Isoimperatorin showed a good linear relationship within a range of 3.668 96-183.448 00 μg· mL-1(r=1).The average of recovery was 96.42%,RSD=2.64%,respectively.Conclusion The established methods are highly specific,stable and reproducible,which can be used as quality control of fengshi bitong capsule.

The article explores the significant role supervisor system plays in the credit system in medical college,the scientific selection of supervisors,their management,duty and directions in order to guide the supervisor system in correct and scientific orbit so as to train constantly new type of medical talents.

Objective To evaluate the clinical effect of talonavicular arthrodesis and the influence of adjacent joints use trephine percutaneous osteotomy in the treatment of talonavicular arthralgia.Methods From June 1999 to June 2009,24 patients were performed talonavicular arthrodesis due to a variety of painful disorder of talonavicular joint with trephine percutaneous osteotomy.There were 13 males and 11 females,with an average age of 45 years(range,37-72 years).The indications for the procedure included 15cases with posttraumatic arthritis,6 cases with rheumatoid arthritis,and 3 cases with degenerative arthritis.AOFAS system and visual analogue scale(VAS)were used to evaluate the change of function and arthralgia.Graves score system was used to evaluate the influence of adjacent joints.Results All patients were followed up 10-120 months,with the mean of 48 months.Only one case suffered skin brim necrosis of incision and got delayed healing after 3 weeks.The average AOFAS ankle-hind foot score improved from 45.2 points preoperatively to 84.5 points postoperatively.The excellent and good rate was 87.5%.VAS pain scores decreased from 8.1 to 2.4 postoperatively.Twenty-three patients were satisfied and one dissatisfied with the results.Postoperative radiology showed the union evidence in 23 patients at 6 months postoperatively(successful fusion rate of 95.8%).One joint nonunion occurred and required revision arthrodesis with iliac crest bone graft.There was an increase of Ⅰ grade in arthritic scores for 8 cases and Ⅱ grade for 1 case.Conclusion Talonavicular arthrodesis with trephine percutaneous osteotomy has the advantages of low trauma,high successful fusion rate and can acquire satisfactory clinical effect in the treatment of painful malalignment of talonavicular joints.

OBJECTIVE:To establish the quality standard for ShutonganⅠgranule.METHODS:TLC was conducted for the qual-itative identification of Citrus aurantium and Forsythia suspensa. HPLC was conducted for the content determination of naringin in the preparation;the column was Agilent C18 with mobile phase of acetonitrile-water(20:80,V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 283 nm,the column temperature was 30 ℃,and the injection volume was 10 μl. HPLC was also used for the content determination of phillyrin;the column was Agilent TC-C18 with mobile phase of acetonitrile- water(23:77,V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 277 nm,the column temperature was 30 ℃,and the injection volume was 10 μl. RESULTS:The C. aurantium and F. suspensa of TLC showed clear spots and good separation. The linear range was 57.843-289.214 μg/ml for naringin(r=0.999 9)and 37.434-187.169 μg/ml for phillyrin(r=0.999 6);RSDs of precision,stability and reproducibility tests were less than 2%;recoveries were 97.20%-102.04%(RSD=1.7%,n=9)and 97.14%-102.27%(RSD=2.0%,n=9),respectively. CONCLUSIONS:The standard can be used for the quality control of ShutonganⅠgranule.

OBJECTIVE:To optimize and improve the quality standards of Daziran wuhua yin. METHODS:TLC was used for the qualitative identification of Cichorii Herba,Glycyrrhizae Radix et Rhizoma and Gossampinus malabarica. HPLC was used for the contents determination of chlorogenic acid and tectoridin. The column was Diamonsil C18 with mobile phase of acetoni-trile-0.4% phosphoric acid(pH adjusted with to 2.05 with triethylamine)(10∶90,V/V,chlorogenic acid or 18∶82,V/V,tectoridin) at a flow rate of 1 ml/min,the detection wavelength was 327 nm(chlorogenic acid)or 265 nm(tectoridin),the column tempera-ture was 25 ℃,and the injection volume was 10 μl. RESULTS:TLC of Cichorii Herba,Glycyrrhizae Radix et Rhizoma and G. malabarica showed clear spots and good separation. The linear range was 19.7-98.7 μg/ml for chlorogenic acid (r=0.999 5) and 25.4-126.8 μg/ml for tectoridin(r=0.999 8);RSDs of precision,stability and reprosucibility tests were lower than 4%,average re-coveries were 97.01%-104.98%(RSD=3.64%,n=9)、98.44%-104.58%(RSD=1.84%,n=9). CONCLUSIONS:The optimized and improved standard is helpful for the quality control of Daziran wuhua yin.

Objective To detect the influence of the perfusion quantity and distribution of bone cement by percutaneous ky-phoplasty(PKP) on the early treatment result of thoracolumbar osteoporotic compression fractures(OVCF) .Methods From May 2011 to May 2013 ,62 cases of osteoporotic fractures of thoracic or lumber vertebra were treated by PKP .CT scans were performed postoperatively to analysis the distribution of the bone cement in the vertebra .According to the bone cement distribution on the transverse plane CT film ,the results were classified into four degrees :excellence ,good ,fair and poor .The cases were followed-up regularly .Preoperative and postoperative visual analogue scale(VAS) ,oswestry dysfunction index(ODI) ,height of the operated ver-tebra ,cobb angle ,the incidences of complications during and after the surgery were compared between groups of different degrees of bone cement distribution and different amount of bone cement injection .Results Among the 62 cases ,the follow-up time ranged from 3 to 36 months[average(10 .5 ± 5 .3)months] .In all of the cases ,there was statistically significant difference between the pre-operative and postoperative VAS scoring(P< 0 .05) .3 months after suergery ,there were no statistically significant influence on the results of VAS scoring ,the ODI scoring ,the height lost of the operated vertebra and the improvement of the Cobb angle(P> 0 .05) . In cases of bone cement injection more than 5 mL ,adjacent vertebra fractures happened in 3 cases 6 months postoperatively and 6 cases 12 months postoperatively .In cases of bone cement injection less than 4 mL ,there were only 2 cases of adjacent vertebra frac-tures happened 12 months posoperatively .The degree of vertebra height lost between the bone cement excellent group and poor group was statistically significant in 6 months and 12 months postoperatively .In cases when the distribution of bone cement was ex-cellent ,the improvement of pain and function was significantly different(P< 0 .05) .Conclusion OVCF is treated by PKP .Through conventional operation ,the ultra-early(within 3 months)efficacy is excellent ,in cases of different amount of bone cement injection and different degree of bone cement distribution .However ,with appropriate amount of bone cement ,the more eventfully and sym-metrically the distribution of the bone cement is ,the better of the early clinical results ,probably .