Objective To investigate the surgical treatment of Maisonneuve injury associated with posterior malleolus fracture under direct visualization via the posterolateral approach.Methods Between January 2008 and June 2015,27 patients with Maisonneuve injury associated with posterior malleolus fracture were treated at our department.They were 18 men and 9 women,aged from 20 to 60 years (average,40.1 years).All fractures and syndesmoses received open reduction under direct visualization and internal fixation via the posterolateral approach.The posterior malleolus fractures were fixed with screws or plate and the syndesmoses fixed using cortical bone screws.Functional results were evaluated using the Baird-Jackson ankle scoring system.Results The patients were followed up for 8 to 30 months (average,18 months).No wound infection,necrosis,dehiscence,lose of reduction or implant failure was found during follow-up visits.All cases got bony union at the last visit.The excellent and good rate was 92.6％.Conclusion Since the posterolateral approach allows good access to the Maisonneuve injury and posterior malleolus fracture under direct visualization,it facilitates accurate direct fracture reduction,stable fixation and early exercise.

Bone Density Conservation Agents ; therapeutic use ; Bone Neoplasms ; complications ; drug therapy ; secondary ; Breast Neoplasms ; pathology ; Diphosphonates ; therapeutic use ; Female ; Humans ; Male ; Pain ; drug therapy ; etiology ; Prostatic Neoplasms ; pathology ; Quality of Life

Objective To investigate the distribution of ompA gnne in 15 Chinese reference standard strains belonging to 15 serogroups of Leptospira interrogate, and to express recombinant OmpA ( rOmpA ) and to identify immunogenicity and immunoprotection of rOmpA. Methods Genomic DNAs from different leptospiral strains were extracted by phenol-chloroform method. Entire ompA gene fragments from the strains were amplified by PCR and then sequenced after T-A cloning. A prokaryotic expression system of ompA gene from L. interrogans strain 56601 was constructed, and the expression and yield of rOmpA were determined by SOS-PAGE plus Bio-Rad Agarose Image Analyser. Rabbits were immunized with rOmpA for obtaining antiserum, and immunodiffusion test was used to measure the antiserum's titer. Western blot assay was performed to determine the immunoreaetivity of rOmpA with the antiserum against rOmpA and antiserum against whole cell of L. interrogans strain 56601, while mi-croscopic agglutination test (MAT) was applied to detect the cross agglutination to the 15 L. interrogans strains. A leptospire adhering cell model and a leptospire infecting guinea pigs model were used to determine the adhesion-bloc-king effect of rOmpA antiserum and immunoprotection of rOmpA. Results All the 15 L. interrogans strains, but not L. biflexa strain Patoe Ⅰ , had sequence conserved ompA genes. The yield of rOmpA was approximate 20% of the total bacterial proteins, rOmpA could induce rabbits to produce antibody and immunodiffusion titer of the anti-serum was 1:4. Both antisera against rOmpA and against whole cell of L. interrogans strain 56601 were able to pro-duce positive Western blot signs to rOmpA, and the former offered 1 : 20-1 : 320 MAT titers to the 15 L. interrogans strains. 1: 10-1:160 dilutions of rOmpA antiserum could efficiently block L. interrogans strain 56601 adhering to J774A. 1 cells, and 100 μg and 200 μg rOmpA displayed 50.0% and 75.0% immunoprotective rates in the infee-ted guinea pigs. Conclusion ompA gene only exists in genomes of different pathogenic L. interrogans serogroups. rOmpA has relatively stronger antigenicity, cross immunoreactivity and certain immunoprotection, implying that this recombinant protein may be used as a candidate antigen for developing universal genetic engineering vaccine of L. interrogans.

The intra-tumor MTX concentration was measured in 12 patients with cerebral gliomas and 31 patients of malignant gliomas were treated with intracarotid infusion of papaverine and bis-chloroaitrosourea (BCNU). After intracarotid infusion of papaverine to open up the blood-brain-barrier (BBB), the MTX concentration within tumor tissues was 1854? 512ng/gram, which higher than that without papaverine infusion, which was 1020? 512ng/gram. The diagnosis was glioblastoma in 21 patients and anaplastic astrocytoma in 10. They received the infusion for a mean of 2.1 times with 250mg BCNU each. The mean survival time was 101.6? 32.7 weeks, with 104 weeks of median survival time. Fourteen were still living, including 11 glioblastoma and 3 anaplastic astrocytoma. Of those, four have lived over three years. We considered combination of papaverine and BCNU infusion for chemotherapy of malignant cerebral glioma is simple, safe and effective, so long as tumors were susceptible to the chemotherapeutic drugs.

Objective:To evaluate the status quo and influencing factors of hyperlipidemia management in patients with contracted family doctor service in the community.Method:The baseline data and blood lipid testing results of 752 hyperlipidemia patients (334 males and 418 females) with contracted family doctor service in Yuetan Community Health Service Center from November?2019 to May 2020 were collected. The hyperlipidemic patients were managed by family doctors based on atherosclerotic cardiovascular diseases(ASCVD) riks assessment. The ASCVD risk levels and low-density lipoprotein cholesterol (LDL-C) compliance rate of patients with different general data were compared, and the influencing factors of LDL-C control failure were analyzed by logistic regression.Results:The ASCVD risk assessment showed that among 752 patients there were 172 cases of low risk(22.87%), 167 cases of moderate risk(22.21%),352 cases of high risk(46.81%) and 61 cases of extremely high risk(8.11%). A significant difference was detected in sex,rate of smoking,incidence of overweight or obesity among patients with different ASCVD risk levels ( P<0.05).The overall control rate of LDL-C was 48.8% (367/752), that for low, moderate, high and extremely high risk patients were 83.73% (144/172), 53.89% (90/167), 34.38% (121/352) and 19.67%(12/61), respectively. A significant difference was detected in sex(female: 52.87%, 221/418),age(aged over 80: 58.82%, 110/187), rate of smoking (non-smoking:52.40%, 327/624) and medication compliance (good compliance:52.87%,221/418) between LDL-C control and uncontrol groups (χ2=6.323,11.816,19.022,25.274; P<0.05). Multiple logistic regression analysis revealed that male gender ( OR=1.800,95% CI:1.325-2.419), smoking ( OR=2.630,95% CI:1.726-4.007) and poor medication compliance ( OR= 2.179, 95% CI: 1.581-3.003) were independent risk factors for uncontrolled LDL-C levels. Conclusion:Patients with hyperlipidemia have a relatively high risk of cardiovascular diseases, and their blood lipids are not well controlled. The management of blood lipid should be enhanced in patients with chronic diseases, particularly for male patients with smoking and poor medication compliance.

Partial nature of "promoting blood circulation and dieresis" of Salvia Miltiorrhizain was initially demonstrated by investigating the regulation effect of AQP2 expression in kidney of trauma blood stasis model rats with the Salvia Miltiorrhizain so as to provide guidance for its clinical deployment of administration. Random allocation was taken to averagely divide 30 SD rats into two groups: 10 rats in normal group and 20 rats in blood stasis syndrome group. Trauma blood stasis rat model was established by quantitatively beating. Then the rat model group was divided into model group and salvia group. After 7 days of treatment, the rat kidney AQP2 expression was detected, the content of urine AQP2 was compared and the damaged local muscle and kidney pathological changes were observed by immunohistochemical method and western blot method. Compared with that of the normal group, rats in model group had inflammatory cells infiltration, blood stasis and edema of the injured local muscles and up-regulated AQP2 expression, decreasing urinary output, and kidney tissues blood stasis and edema (P < 0.05). On the other hand, compared with that of the model group, those parameters of rats in salvia group were all decreasing except urine output (P < 0.05). Such result indicated that Salvia Miltiorrhiza can reduce trauma blood stasis rat content of urine AQP2 and down-regulated AQP2 expression in kidney tissue, so as to reduce the reabsorption of water by renal tubular and increase urine output. The promoting blood circulation effect of Salvia Miltiorrhizain can alleviate the degree of the damaged tissue edema and encourage urine drainage. This therapy is closely related to the effect of regulating AQP2 in kidney by salvia, so the purpose of this study by verifying "promoting blood circulation and diuresis" as the mechanism for the regulation effect of the salvia on AQP2 expression.
Animals ; Aquaporin 2 ; genetics ; metabolism ; Blood Circulation ; drug effects ; Diuresis ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Kidney ; blood supply ; drug effects ; metabolism ; physiopathology ; Kidney Diseases ; drug therapy ; genetics ; metabolism ; physiopathology ; Male ; Rats ; Salvia miltiorrhiza ; chemistry

TCM syndrome differentiation system (TCM-SDS) possesses a complex nonlinear characteristic, which determines the falt that the evaluation of TCM efficacy should not be simplified to a causal or linear relationship. Previous selected indexes and methods for evaluating curative effect of Child's pneumonia have their limitations. This paper mainly introduces several thoughts and methods formed in the exploratory researches, employing data mining technology in this field. We believe that efficacy evaluation research of Child's pneumonia on the basis of standardized study of TCM-SDS is a scientific work. Applying data mining method in processing enormous and multilayer information of TCM differentiation has strong advantages in screening evaluating indexes of Child's pneumonia. Meanwhile, some major concerning technical categorizations and implementing strategies for the research are also introduced.
Algorithms ; Automatic Data Processing ; methods ; Child ; Child, Preschool ; Data Interpretation, Statistical ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infant ; Male ; Medicine, Chinese Traditional ; methods ; standards ; Outcome Assessment (Health Care) ; methods ; statistics & numerical data ; Phytotherapy ; Pneumonia ; diagnosis ; drug therapy

OBJECTIVETo evaluate the clinical efficacy of combined internal-external therapy of TCM on children pneumonia. Adopting multi-center, randomized, controlled, double blinded principle, children with pneumonia were divided into 2 groups. Besides the basic treatment of western medicine, to the 406 children in the treated group internal administering of Chinese recipe prescribed according to syndrome differentiation and external applying of Fuxiong plaster were given additionally, while to the 411 children in the control group simulative placeboes were given for instead. The clinical efficacy of treatment on disease and syndrome, improvement of TCM syndrome and physical signs of lung between the two groups were compared after treatment.

RESULTSThe cured-markedly effective rate of treatment on disease and syndrome was 97.3%, 95.1% in the treated group and 89.8%, 86.6% in the control group, respectively, the differences of the two indexes between the two groups were significant (P < 0.05). The improvements on physical signs of lung, symptoms as cough, dyspnea and sputum expectorating in the treated group were significantly better than those in the control group (P < 0.05).

CONCLUSIONIt was showed that the combined internal-external TCM treatment, which could significantly enhance the clinical efficacy, is an effective therapy for children pneumonia.

Administration, Cutaneous ; Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Infant ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Pneumonia ; therapy ; Treatment Outcome

This paper is to build a finite element model of brain with a real brain shapeon which simulation studies of electrical impedance tomography EIT in the brain is based. A curve of a real brain shape is simulated with the curve-fitting methods and EIT in the brain is finished with finite-element methods and Equipotential Lines Back-Projection algorithm.The locationarea and amplitude of the change of the resistivity are reconstructed accurately. But the image quality has to be further improved.This paper provides a basis for clinical applications of EIT in brain.

The purpose was to compare the difference between transgene expressions driven by homologous duplicated carbonic anhydrase (DCA) promoter and foreign CaMV35S promoter in the unicellular green alga, Dunaliella salina(D.salina).The CaMV35S promoter-bar construct and DCA promoter-bar construct into D.salina by a Backon 2000 electroporation system were introduced. After the repeated selections with the phosphinothricin (PPT) of 3mg/L, 3 PPT-resistant phenotype transformants were isolated from the CaMV-bar and DCA-bar pools of transformants of D. salina, respectively. The results of PCR and sequencing showed that bar genes were stably integrated into the genome of D.salina, and Southern bolts showed the number of transgene copy had no significant difference between both promoters. Semi-quantitive RT-PCR indicated that the mRNA levels of bar gene were higher in DCA-bar transformants than the CaMV-bar transformants, and could be increased under the induction of high salt in DCA-bar transformants but not in the CaMV-bar transformants. Analysis of growth rate of transformants showed DCA-bar transformants achieved the log stage faster than the CaMV-bar transformants. It is concluded that the homologous promoters have more advantages than the foreign promoters in the transgenic D.salina.