Objective To evaluate the effect of the interlocking nail for extremity fractures. Methods This study reviews 1224 cases of extremity fractures treated with locking intramedullary nail fixation from October 1996 to June 2004, including 92 cases humeral shaft fracture; 210 cases intertrochanteric fractures; 488 cases femoral shaft fractures; 92 cases supracondylar femoral fractures; 342 cases tibia and fibular fractures. According to the AO classification there were 642 type A, 364 type B and 218 type C. There were 986 cases (72.4%) high-energy injury; 405 cases were multiple injury. There is 778 male and 446 female with mean age 39 years (range 16-92 years). Duration from injury to operation was 8 days(3 hour-30 days). Close reduction was 1203 cases and open reduction were 21 cases. Results Mean follow-up period is 24 months(6-70 month), mean operation time was 90 minutes(40-480 minutes). Union was in 1204 cases, union rate was 98.2%, mean union time was 5 months (3-12 months) on average, there were nonunion in 22 patients: 4 in humeral shaft, 8 in femoral shaft, 4 in supracondylar femur, 6 in tibia shaft, the nonunion rate is 1.8%. Late deep infection occurred in 3 patients: 1 in femoral shaft, 1 in supracondylar femur, 1 in intertrochanteric femur, the infection rate is 0.2%. There were 16 split in intraoperation: 4 in humeral nail, 4 in Gamma nail, 9 in supracondylar nail. Iatrogenic nerve palsy occurred in 6 patients: 2 in radial nerve, 2 in sciatic nerve, 2 in common peroneal nerve, the occurrence is 0.4%. One femoral nail was broken, locking screw were broken in 9 patients (0.6%), femoral shaft fracture of distal nail end occurred in 3 cases: 1 in Gamma nail, two in supracondylar nail. 53 patient complained uncomfortable in entry point (8 shoulders; 9 hips; 36 knees). Conclusion The result is satisfactory in bone healing low infection reduced blood loss and rapid recovery of the joint and body with the close interlocking nailing to be treatment of fresh extremity shaft fracture. It is a perfect method, however the complication should be pay more attention.

Objective To analyze and evaluate the related data of bottom clearance in Fuling section of Three Gorges Reservoir. Methods Bottom clearance in Fuling section of Three Gorges Reservoir was carried out in Fuling district during the period from May to December in 2002. All the data related to clearance were collected before and after the bottom clearance. Based on the collected data, the effect of clearance was assessed. Results 5 882 general pollution sources, 68 contagion pollution sources were cleaned in Fuling district, the clearance rates of both were 100%. The rat densities in agriculture areas and the dismantling cities were 3.97% and 2.97% respectively before rat extinguishment, then became 0.65% and 0.33% after rat extinguishment. Conclusion Through the bottom clearance of Three Gorges Reservoir, contagion and general pollution sources in the emigrant areas have been cleaned up, so water pollution in Three Gorges Reservoir and the rats mediated diseases have been prevented and controlled.

Objective To evaluate the efficacy and safety of vasopressin(Pitr- essin)on esophageal variceal bleeding in patients with cirrhosis.Methods 42 cirrhotic patients with acute esophageal variceal bleeding confirmed by endoscopy were randomly divided into 2 groups and administered with Pitressin and Pituitrin for 48 hrs respectively.The balloon tubes were placed in the stomach before the treatment,and the duration of hemostatsis,volume of transfusion,rebleeding and short-term survival period were recorded.Results After 12 hrs treatment,the hemostatic rate in Pitressin group was 72.7%,significantly higher than that in Pituitrin group(40.0%,P

CT data regarding PUMCⅡ d2 adolescent idiopathic scoliosis obtained from one female patient were input into modeling software minics 11.11 to obtain medical simulation model.Then finite element analysis models of AIS patients (T1-S) were created by introducing simulation models into software abaqus 6.7.Finite element models of T6 11 segments were corrected by 5 different correction methods:simple concave bracing,simple convex pressurization,concave distraction and convex compression simultaneously,concave distraction prior to convex compression and concave distraction after convex pressurization.Abaqus software was used to simulate correction of scoliosis with vertebral arch pedicle screw by loading 50 N,100 N,and 200 N distraction forces on the concave side pedicles of the end vertebrae T6 and T11.The displacement of vertebrae T6 in Y-axis (sagittal plane) and Z-axis (coronal plane),which respectively represented the correction effects of kyphosis and scoliosis,was compared between prior to and after correction.Simple concave distraction provided better outcomes in terms of displacement of T6 in Z-axis than the remaining four methods (P ＜ 0.01).Concave distraction and convex compression simultaneously,concave distraction prior to convex pressurization and concave distraction after convex compression produced identical displacements of T6 in Y-axis,which were all better than simple concave distraction (P＜ 0.01).The present findings imply that for curative effects of five methods on correction of scoliosis in the coronal plane:simple concave distraction＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compressio= concave distraction after convex compression ＞ simple convex pressurization;for curative effects of five methods on correction of kyphosis in the sagittal plane:simple convex compression ＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compression= concave distraction after convex compression＞ simple concave bracing.Simple concave distraction could not produce obvious corrective effects on kyphosis rather than lead to worsened kyphosis to some extent.Simple convex compression could not produce obvious corrective effects on scoliosis rather than result in aggravated scoliosis to some extent.

Objective To investigate the protection mechanism of ulinastatin on bacterial endotoxin-induced acute lung injury. Methods Acute lung injury was induced by Escherichia colilipo-polysaccharide(LPS)5 mg·kg-1·d-1,intratracheally. Twenty SD rats were randomly divided into control group(n=10)and ulinastatin group(n=10). Ulinastatid group received ulinastatin 50 kU·kg-1 ,the control groups received the same amount of 0. 9% sodium chloride solution. Then the expression changes of rat AQP-1 and AQP-5,alveolar wall thickness change and the degree of pulmonary edema were detected. Results After the injection of LPS into the rat,the expression of AQP-1 and AQP-5 in control group were continuously decreased,but those in ulinastatin group decreased were not obvious. The lung wet/dry weight ratio in the control group increased significantly,the not obvious changes in the ulinastain group. The thickness of the alveolar in 24,48,72 h of the control group were(3. 84±0. 68),(6. 32±1. 08),(11. 03±2. 47)μm, respectively,and those in the ulinastian groups were(2. 31±0. 44)(,3. 76±0. 82)(,2. 94±0. 67)μm,respectively. Conclusion The AQP-1 and AQP-5 induced the occurrence of pulmonary edema by changing the cell permeability. Ulinastatin can slow down the process so as to reduce the degree of endotoxin-induced lung injury.

Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

Objective To investigate the characteristics of clinical course and outcome in elderly patients with nonvariceal upper gastrointestinal bleeding (NUGB) Methods The 206 hospitalized patients were devided into elderly group (≥60 yrs, 105 cases) and non elderly growp (

Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.

Objective Via targeted inhibition of oncogene Bmi-1 expression by RNAi interfering technology in vitro, to observe its effect on the proliferation and cell cycle of gallbladder cancer cells. Methods Four miRNABmi-1 recombinant plasmids were constructed according to different Bmi-1 sites. RT-PCR and Western blot were used to mRNA and protein expression of Bmi-1 in gallbladder cancer cells were measured by RT-PCR and Western blot. mRNA and protein expression of Bmi-1 in gallbladder cancer cells. The most effective interfering plasmids in the miRNABmi-1 groups were transfected into GBC-SD cells. Cell proliferation and cell cycle were analyzed 48 h after transfection by BrdU and flow cytometry. Results Bmi-1mRNA expression in miRNAbmi1-1,-3 and-4 was significantly lower than the control group (P<0.05);and Bmi-1 protein expression in miRNAbmi1-2,-3 and-4 was significantly lower than the control group (P<0.05). The recombinant plasmid in miRNAbmi1-4, with the strongest inhibitive effect of Bmi-1mRNA and protein expression, was transfected into GBC-SD cells,then the cell proliferation rate (46.63 ± 5.31) was significantly lower in mRNABmi1-4 group than the control groups (P<0.05);G0/G1 phase cells increased (72.20 ± 1.71) and G2/M and S phase cells decreased (18.30 ± 7.21, 9.50 ± 6.01) in miRNABmi1-4 group. Both were significantly different from the control groups (P<0.05). Conclusions Targeting and silencing Bmi-1 expression can effectively inhibit the proliferation of GBC-SD cells and restrain the cell cycle atin G0/G1 phase. Bmi-1 gene may be a novel target for geneic therapy of gallbladder carcinoma.

Objectives To explore the role of PKCβ/p66Shc oxidative stress signaling pathway in hyperoxia-induced apoptosis of alveolar epithelial cells A549. Methods A549 cells were cultured in vitro and divided randomly into control (incubated with 5%CO2), hyperoxia group (exposed to a mixture of 900 ml/L O2 and 50 ml/L CO2 at speed of 3 L/min for 10 mins, then cultured in a closed environment) and LY333531 group (treated with 10μmol/L of PKCβinhibitor LY333531 for 24h then induced with hyperoxia for 10 mins). The cellular morphology was observed under inverted microscope at 12, 24 and 48 h of treatment. The cell apoptosis was detected by lfow cytometry. Expression of PKCβ/Pin1/p66Shc/p66Shc-Ser36 were detected by immunohistochemistry after 24 h of treatment. Results Comparing to the control group, the cellular morphology of A549 in the hyperoxia group changed to spherical shapes and space between cells increased, the living cell count decreased and suspension cell increased. The living cell count in LY333531 group increased and suspension cell decreased than those in hyperoxia group but not reach the levels of the control group. The apoptosis rate of A549 cells and the expression of PKCβ/Pin1/p66Shc/p66Shc-Ser36 at 24 h were signiifcantly increased in the hyperoxia group than those in the control group, while the apoptosis rate and the expression of PKCβ/Pin1/p66Shc/p66Shc-Ser36 were greatly decreased in the LY333531 group than those in the hyperoxia group (all P<0.01). Conclusions The expression of PKCβin A549 cells can be increased by the hyper-oxia induction but reduced by LY333531, and then the expressions of Pin1, p66Shc and p66Shc-Ser36 are reduced. Thus the re-duced apoptosis of A549 cells relieve the cell injury induced by hyperoxia.