[Objective]To explore clinical class,surgical treatment and clinical results of clavicle fracture with internal fixation.[Method]A retrospective analysis of 146 cases of clavicle fracture was reported.Totally 146 cases of clavicle fracture accepted by our department from January of 1996 to June of 2006 were carried out the operation using plate shaft.There were 98 males and 78 females.Aged from 8 to 84 years,average of 38.6 years.The average age of the patients at surgery were 38.6 years(ranged 8 to 84 years).There were 9 cases in proximal 1/3,115 cases in middle 1/3 and 12 cases in distal 1/3 of clavicle,accompanied by 7 cases of brachial-plexus injury,4 cases of vascular injury,16 cases of another fracture.There were 7 cases of old clavicle fracture.Surgical methods: Both proximal 1/3 and middle 1/3 of clavicle fracture were treated by AO reconstruction plate or similar plate.Fracture pieces of clavicle were enlaced with screws or steel wire before fixation with plate.The distal of clavicle fracture should be fixed with 3 screws.The distal 1/3 of clavicle fracture with acromioclavicular luxation was treated by reconstruction plate or c clavicle hook plate.Patient could exercise their shoulder joint at 48 hours postoperatively.Post operative evaluation: Clinical results of clavicle fracture with internal fixation were evaluated with appearance,fracture healing time, shoulder joint function and living quality around fracture.[Result]Patients were followed up more than 6 months after operation.Adopt Neer standard to evaluate the patient's function after the operation.There were excellent results in 96 cases and good in 50 without injury of subclavicular nerve and blood vessel,infection,loose and prolapse of internal fixation devices and fracture disunion and malunion and macrosis bony callus.X-ray shows clavicle fracture healing completely.The patients can get painless free-running.[Conclusion]Internal fixation for treatment of clavicle fracture is characterized by little wound,firm fixation and early movement of the joint and is an effective method to cure clavicle fracture.

Ovbective To evaluate the outcome of the complete repair for critical and complex congenital heart defects in small infants with cardiopulmonary bypass. Methods A retrospective review of hospital records was performed for 187 infants under 6 months undergone cardiac operation from January 2000 to January 2004. Average age was (4.15?2.32) months (3d-6months) and average weight was (4.42?0.56)kg (3～7kg). The diagnoses included ventricular septal defect with pulmonary hypertension,transposition of the great arteries,aortic coarctation with other lesions,total anomalous pulmonary venous connection,tetralogy of Fallot,atrioventricular canal defect,pulmonary atresia,and neonatal cardiac tumor. Average duration of mechanical ventilation was (17.5?9.7) hours. ICU stay was (4.9?1.5) days. Results 9 cases died after operation with a hospital mortality of 4.81%. Postoperative complications included low cardiac output syndrome,residual shunt,pulmonary infection and pulmonary hemorrhage. 178 are alive and in good cardiac status at follow-up of 4～48 months. After repair,growth approximates the normal. Conclusion With the development of pediatric cardiac surgery, cardiac operation with CPB in small infants with critical and complex congenital heart defects is feasible and may provide satisfactory survival.

Objective To study the protection of Kangnaoling capsule to free radical injury and influence on the expression of caspase-3 and Bcl-2 in neuron of VD rat. Methods VD rat model was duplicated. Using spectrophotometry to detect contents of SOD, MDA and NO, spectro-fluorimeter to detect the expression of caspase-3, spectrophotometric method to detect the expression of Bcl-2 after traditional Chinese medicine interference. Results Kangnaoling capsule can markedly reduce the contents of MDA, raise contents of SOD and NO, degrade the expression of caspase-3, enhance the expression of Bcl-2. Conclusions Kangnaoling capsule can markedly protect VD rat from free radical injury, which probably correlated with increasing expression of Bcl-2, decreasing expression of caspase-3.

Objective:The clinical features,maternal and fetal outcomes and management of pregnant women with uterine malformation during the pednatal period were investigated.Methods:99 pregnant patients with uterine malformation as research group and 100 pregnant patients without uterine malformation as control group were recruited in Peking Union Medical College hospital from January 1 st in 2000 to September 30th in 2008.A retrospective study was done to compare the clinical features,matemal and fetal outcomes in these two groups.Clinical management of pregnancy with uterine malformation.Results:In the research group,the incidence of caesarean section,threatened abortion,preterm rupture of membrane,abnormal presentation,and placenta accrete were higher than those in the control group.The average fetal weight was smaller than that of control group.There were no significant differences in postpartum hemorrhage and perinatal child death in these two groups.Conclusions:Patients with uterine malformations more likely undergo C-section.Postpartum hemorrhage and other pregnant complications should be paid more attention.

AIM:To research the characteristics of ventricular electrophysiology in right ventricular rapid pacing-induced congestive heart failure (CHF) dogs. METHODS:Dogs (n = 16) were randomly divided into 2 groups:the control (n = 7) and the CHF group (n = 9) induced by rapid right ventricular pacing at 240 pulse·min-1 for 4 to 5 weeks. The electrophysiologic parameters were evaluated by the technique of standard electric stimulation and monophasic action potential (MAP) recording. RESULTS:(1) Ventricular effective refractory period (VERP), ventricular MAP duration (MAPD90), ventricular late repolarization duration (VLRD) and intra- ventricular conduction time (IVCT) were prolonged by 26％ (P ＜ 0. 01), 43％ (P ＜ 0. 01), 318％ (P ＜ 0. 05), and 19％ (P ＜ 0. 01), respectively in CHF group. (2)The ratio of VERP to MAPD90(VERP/MAPD90) was decreased by 13％ (P＜0.05) in CHF group. (3) The dispersion of ventricular recovery time (VRT - D) was increased by 185％ (P ＜0. 01) in CHF group. (4) The ventricular fibrillation threshold (VFT) was decreased by 48％ (P ＜ 0. 01) in CHF group. CONCLUSION:The abnormal electrophysiological changes in the CHF condition may be contributing factors of lethal ventricular arrhythmias and sudden cardiac deaths in CHF.

A three-dimensional (3D) transrectal ultrasound (TRUS) imaging system is presented in this paper. The 3D imaging system is used for diagnosing diseases of prostate. The 3D image is reconstructed by a series of two-dimensional image data which is obtained through rectum. It can be a guide to prostate needle biopsies. The system is built by two parts: hardware and software. In the hardware, the mechanical device, stepper motor, control circuit, B Mode TRUS and personal computer (PC) workshop are presented. The software includes the firmware of micro control unit and software of the PC workshop. In order to evaluate the performance of the 3D imaging system, we did experiments with water and agar phantoms, and the results demonstrated the system's ability of 3D imaging with high-precision.
Biopsy, Needle ; Humans ; Imaging, Three-Dimensional ; instrumentation ; Male ; Phantoms, Imaging ; Prostate ; diagnostic imaging ; Rectum ; Software ; Ultrasonography

Objective To establish a distinct linked emergency rescue network system in Shenzhen. Methods The current status of emergency network system in Shenzhen was studied, and some related publications in the recent years were reviewed. Results The emergency network system in Shenzhen is characterized by the following aspects: there is an effective emergency dispatch system with high authorities; the network covers every corner of Shenzhen; series of laws have been issued to ensure the proper operation of network. Conclusion The medical rescue system has developed in depth. The combination of community-based, pre-hospital and hospital rescue is effective in the whole process of emergency rescue, and shortens the rescue distance. The community-based rescue is the basic part of the system that can use the medical resources efficiently.

Objective To investigate the correlation between the level change of serum homocysteine (HCY) and vascular endothelial growth factor (VEGF) with the degree of the coronary artery stenosis in the patients with acute coronary syndrome (ACS) .Methods A total of 157 ACS patients were divided into the ST‐elevation myocardial infarction (STEMI) group ,non‐ST el‐evation myocardial infarction (NSTEMI) group and unstable angina pectoris(UA) group based on the symptoms ,cardiac enzymes level and electrocardiogram changes .The cases were induded into the mild ,moderate and severe stenosis lesion groups according to the coronary arteriography examination;meanwhile the enzyme‐linked immunosorbent assay (ELISA) was used to detect the change of the serum VEGF concentration .The HCY level was determined by enzymatic cycling methods with the biochemical analyzer (BXC800 ,Beckman ,USA) .The differences in the concentrations of VEGF and HCY compared among different groups .Results The VEGF level had statistical differences among the mild ,moderate and sever stenosis groups(F=39 .9 ,P=0 .00) ,and between the UA group with the NSTEMI group and STEMI group(F=123 .3 ,P=0 .00) .The HCY level had statistically significant differ‐ence between the severe stenosis group with the mild and moderate stenosis groups (F=39 .7 ,P=0 .00);the HCY level had statis‐tically significant difference among the UA group ,NSTEMI group and STEMI group(F=102 .65 ,P=0 .00) .The VEGF and HCY levels in the mild stenosis group ,different degrees of coronary stenosis groups and different clinical diagnosis groups were positively correlated with the Gensini scores(r=0 .723 ,0 .716) .Conclusion The serum VEGF and HCY levels are correlated with the degree of the coronary artery lesion and myocardial necrosis in ACS patients ,furthermore are related with the Gensini scores .

BACKGROUND: High oxalic acid urine is a risk factor for stone formation. Constructing cel lines with high oxalate metabolic ability using genetic engineering and stem cel technology wil become the effective method to prevent and treat calcium oxalate stone. OBJECTIVE: To construct the adult bone marrow mesenchymal stem cel lines that can decompose the oxalic acid, through co-transfecting the oxalic acid degradation genes Frc and Oxc of oxalobacter formigenes into the normal adult bone marrow mesenchymal stem cells. METHODS: Frc and Oxc were amplified by PCR, and the eukaryotic expression vectors of pLEGFP-N1-myc-Frc and pBaBE-puro-flag-Oxc were constructed, then co-transfected into the normal adult bone marrow mesenchymal stem cells. The non-transfected bone marrow mesenchymal stem cells and the cells transfected with empty vectors were as control. Western blot was performed to detect the expression of the objective genes;the concentration of oxalate in the culture medium after transgenic was determined by ion chromatography. RESULTS AND CONCLUSION: Restriction enzyme digestion and sequencing results showed that the Frc and Oxc genes were successful y amplified, and the vectors of pLEGFP-N1-myc-Frc and pBaBE-puro-flag-Oxc were constructed. After tranfected into the bone marrow mesenchymal stem cells, the Western blot results showed that transfected bone marrow mesenchymal stem cells could stably express the target protein myc-formyl coenzyme A transferase enzyme and the flag-oxalyl coenzyme A decarboxylase; ion chromatography test results showed with the prolonging of the culture time, the concentration of oxalic acid in the human bone marrow mesenchymal stem cel culture medium transfected with target gene was decreased gradual y. While there was no target protein expression in the non-transfected human bone marrow mesenchymal stem cells as wel as the cells transfected with empty vectors. The cells had the ability of oxalate-degradation. The experiment successful y constructs the adult bone marrow mesenchymal stem cel lines that can decompose the oxalic acid, and the cel lines have the ability of oxalate-degradation and can stably express the oxalate decomposition proteins Frc and Oxc.

Objective To evaluate the association of angiotensin (AGT ) gene M235T polymorphism with essential hypertension (EH) .Methods The literatures examining the association of the M 235T polymorphisms with EH were selected in electronic data-bases .Using RevMan5 .0 ,heterogeneity and pooled effect sizes were calculated .Results Totally ,29 articles ,with 5 971 cases and 6 443 controls were finally included in this study .The odds ratio (OR) value of TT+ TM∶MM genotype was 1 .13 (95% CI 1 .00-1 .25 ,P=0 .04) in worldwide populations .Subgroup analysis showed that the OR values of TT ∶MM genotype were 1 .13 (95% CI 0 .90-1 .42 ,P=0 .28) in subjects published before 2008 and 1 .29(95% CI 0 .94-1 .75 ,P=0 .11) in those after 2008(year of 2008 included) .The OR values of T ∶M in Han population was 1 .24 (95% CI 1 .01-1 .53 ,P=0 .04) .Conclusion TT+ TM genotype of the M235T polymorphisms is associated with EH in worldwide populations ,and T allele is also correlated with EH in Han popu-lation .