[Objective]To evaluate the clinical result after treatment on fracture of distal radius with different fixations of the wood splint/plaster splint/"T" model plate.[Method]There were 236 cases with the fracture of distal radius,there were divided three types of A,B,C according to the AO classification,70 cases in 236 cases were treated with close diaplasis and external wood splint fixation,55 in 236 cases with external plaster splint fixation,III in 236 cases with operation and internal "T" model plate fixation.Results were evaluated by replacement and function after treatment,and percentage of excellence was compared with three different fixation.[Result]236 cases were all followed-up,mean follow-up period was 14.6 months(6~20months).The excellence rate of diaplasis was not significantly different in A and B type by comparing three different fixation,the excellence rate of function with wood splint fixation and "T" type plate internal fixation was better than that of plaster splint fixation in A and B type,there were not significantly difference about the excellence rate of function with the external wood splint fixation and the internal "T" model plate fixation.The excellence rate of function and reduction with"T" type plate internal fixation were better than with plaster splint and wood splint in C type.[Conclusion]The author suggests open reduction with "T" type plate internal fixation about C type fracture,close reduction and external wood splint fixation about A and B type distal radius fracture.

Objective To investigate the expression of C/EBP homology protein (CHOP) in peripheral brain tissue of patients with severe traumatic brain injury (TBI) and its correlation with the injury severity.Methods The study included peripheral brain tissues of 41 TBI patients (TBI group).Another 16 autopsy specimens succumbed to other diseases (except for TBI or other central nervous system diseases) were selected as controls.The control group and TBI group were subdivided into immaturity group (≤18 years),adult group (18-59 years) and elderly group (＞59 years).According to Glasgow Coma Scale (GCS) on admission,TBI group was classified as severe TBI group (GCS of 6-8) and particularly-severe TBI group (GCS of 3-5).CHOP expression in peripheral tissues after TBI was compared in between different age,gender and GCS.Nerve cell apoptosis was detected by TUNEL technique and correlation between CHOP level and apoptotic number was analyzed.Results There were no age and gender differences regarding CHOP expression in control group (P ＜ 0.05).Compared with control group,expression of CHOP presented notable up-regulation in TBI group (P ＜ 0.05).Expression of CHOP presented no gender difference in TBI group (P ＞ 0.05),but its expression was lower in the aged than in adult or immaturity (P ＜ 0.05) as well as notably higher in particularly-severe TBI group than in severe TBI group (P ＜ 0.05).Nerve cell apoptosis in TBI group was far greater in number than that in control group (P ＜0.05).A positive correlation was observed between CHOP level and apoptotic index (r =0.72,P ＜ 0.05).Conclusion Expression level of CHOP after TBI is closely related to the injury severity and nerve cell apoptosis,but the apoptosis pathway induced by CHOP may not be a major factor in secondary brain injury after TBI in the aged patients.

Objective To investigate the common reasons for intracranial hemorrhage after cranioplasty ,and to analysis the sig‐nificant perioperative factors of intracranial hemorrhage after cranioplsty .Methods Eight hundred and seventy two cases of cranio‐plasty were retrospectively analyzed ;the postoperative intracranial hemorrhage and perioperative risk factors were conducted with multiple linear regression analysis .Results Among the 872 cases ,46 cases suffered intracranial hemorrhage .We found three signifi‐cant perioperative factors of intracranial hemorrhage after cranioplasty :suspension for epidural ,not completely hemostasis and ex‐cessive drainage in ventriculoperitoneal shunt .Conclusion To avoid the three risk factors as far as possible could effectively reduce the incidence of intracranial hemorrhage after cranioplasty .

Objective Cigarette smoking remains highly prevalent in most countries.It can affect drug therapy by both pharmacokinetic and pharmacodynamic mechanisms.Correlation between smoking and drugs has been reviewed, and the future study about situation of smoking and drugs also was reviewed.

Objective:To analyze the effect of comprehensive nursing education on anxiety, depression, quality of life and survival of patients with hepatocellular carcinoma (HCC) after surgery.Methods:A total of 136 HCC patients were randomly divided into two groups: general nursing education group and comprehensive nursing education group. The comprehensive nursing education group carried out 12 months of health belief education, psychological care, care activities and telephone condolence. The routine nursing group received basic education for 12 months. The changes of anxiety and depression were assessed by hospital anxiety and depression scale (HADS). The quality of life (QOL) of participants within 12 months was assessed using the European research and treatment cancer quality of life questionnaire (QLQ-C30). The 3-year survival of the two groups was compared.Results:There was no significant difference between the two groups in baseline data. At the 9th and 12th month, the HADS-A score of the comprehensive nursing education group was significantly lower than that of the general nursing group ( P< 0.05). In the 12th month, the overall health of QLQ-C30 in the comprehensive nursing education group was better than that in the general nursing group ( P<0.05). The QLQ-C30 function score of the comprehensive nursing education group at the 12th month was better than that of the general nursing group ( P<0.05). There was no significant difference in QLQ-C30 symptom scores between the two groups at all time points ( P>0.05). The overall survival of the patients in the comprehensive nursing education group was better than that in the general nursing group ( P=0.026). Conclusion:the comprehensive nursing education can reduce the anxiety and depression of HCC patients after surgery, and can improve their quality of life and survival.

Objective To investigate the effect and underlying mechanism of apolipoprotein E (APOE) genetic polymorphism in treating blood brain barrier (BBB) breakdown after traumatic brain injury (TBI).Methods Human APOE knock-in mice (ε3,ε4),APOE knockout mice,and APOE wild-type mice with each numbering 80 were respectively divided into TBI group (n =50),sham-operation group (n =15) and normal control group (n =15) according to the random number table.TBI group was subdivided at 1 day (n=15),3 days (n=15),and7 days (n=20).TBI was induced with a pneumatically operated injury device.BBB permeability to large or small molecules was evaluated by measuring Evans blue (EB) and fluorescein sodium (NaFI) extravasation into the damage area at 1,3,and 7 days postinjury.Brain water content was determined using the dry-wet method.Western blotting and qRT-PCR for tight junction-associated proteins Occludin and Claudin-5 were performed at 7 days postinjury.Results With respect to normal control group,BBB permeability to EB and NaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice.There appeared significant increase in BBB permeability to EB and NaFI in TBI group,with insignificant differences among rats of each genotype at 1 and 3 days postinjury (P ＞ 0.05).Whereas at 7 days postinjury,BBB permeability to EB in APOE wild-type and e3 mice returned to the normal level (P ＞ 0.05),but it re mained at a high level in APOE knockout and ε4 mice (P ＜ 0.01).Meanwhile,BBB permeability toNaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice (P ＜ 0.01).Brain water content was equivalent among rats of each genotype at 1,3 and 7 days postinjury (P ＞0.05).Western blotting and qRT-PCR demonstrated Occludin and Claudin-5 in ε4 and APOE knockout mice were significantly lower than those in ε3 and APOE wide-type mice (P ＜ 0.05).Conclusion APOE plays an important role in restoration of BBB function after TBI,but ε4 may impede the recovery of BBB breakdown after TBI through its effect on tight junction.

Objective To develop a nomogram for predicting the risks of early anastomotic recurrence(EAR)after primary bowel resection in patients with Crohn's disease(CD).Methods The patients with CD under-going preoperative magnetic resonance enterography(MRE)and primary bowel resection were enrolled in this retrospective study and divided into an EAR group(18 patients)and EAR-free group(12 patients).The EAR group included the patients having an endoscopic Rutgeerts score of≥I2 month or the need for anastomotic resection within 12 months after surgery.All the 38 indexes including preoperative demographic characteristics,laboratory examina-tions,multi-parameter MRE features of the resected intestine and its adjacent mesentery,histological findings,and postoperative pharmacotherapy were analyzed.Least absolute shrinkage and selection operator(LASSO)regression and multivariate binary logistic regression analysis were performed to identify independent risk factors to be incorpo-rated into the nomogram for predicting the risks of early anastomotic recurrence and the prediction performance was evaluated.Results Mesenteric creeping fat index on MRE and comb sign were independent risks of EAR,with a concordance index of 0.882(95%CI:0.764～1).The calibration plot revealed a strong relationship between actual observation and predicted probability of EAR.Conclusions The preoperative MRE-based nomogram may be a potential tool for predicting EAR following surgery in patients with CD,which is beneficial to individual management in those patients.It provides reference for the formulation of early postoperative individualized drug adjuvant therapy in patients at high risk of EAR.

Objective To investigate the diet-related influencing factors in patients with gallbladder stone. Methods Forty patients with gallbladder stone who were admitted to the Third Affiliated Hospital of Sun Yat-sen University between July 2015 and September 2015 were enrolled in this prospective study, as the stone group. Another 40 healthy people were selected as the control group. The informed consents of patients in two groups were obtained and the local ethical committee approval was received. A cross-sectional survey was conducted to compare the baseline data, body mass index, serum lipid level, dietary composition, living habit and dietary intake between two groups. Normally-distributed data of two groups were compared by t test, and the rates were compared by Chi-square test or Fisher's exact probability test. Results A majority of patients in the stone group were farmers with junior education background, living in rural areas. The high-density lipoprotein cholesterol (HDL-C) level in the stone group was (1.1±0.3) mmol/L, significantly lower than (1.4±0.4) mmol/L in the control group (t= -3.616, P<0.05). The apolipoprotein A (apoA) level in the stone group was (1.27±0.16) g/L, significantly higher than (1.09±0.27) g/L in the control group (t=2.947, P<0.05). The percentage of eating fat pork in the stone group was 80% (32/40), significantly higher than 35% (14/40) in the control group (χ2=8.286, P<0.05). The percentage of eating cereals and dairy products in the stone group was respectively 10% (4/40) and 20% (8/40), significantly lower than 80% (32/40) and 90% (36/40) in the control group (χ2=19.789, 19.789; P<0.05). There were significant differences in the preference for fatty diet, dietary composition, drinking habit, breakfast habit, eating habit, smoking habit, hand-washing habit and exercise time between two groups (P<0.05). The daily intake of water, dairy products and fruits in the stone group was respectively (743±379) ml, (33±4) g and (128±39) g, significantly less than (1 410±406) ml, (233±88) g and (275±43) g in the control group (t=-5.373, -7.790, -3.293; P<0.05). The daily intake of poultry and edible oil in the stone group was respectively (112±35) and (43±12) g, significantly higher than (21±8) and (22±9) g in the control group (t=4.706, 8.854; P<0.05). Conclusions Lack of diet-related knowledge, high-fat and low-protein diet, irregular eating habit, insufficient drinking water and lack of exercise may probably be correlated with the incidence of gallbladder stone.