Objective To investigate the effect of internal fixative operation with special-shaped plate on Pi- lon fracture.Methods 84 cases of Pilon fracture were treated respectively by continuous skeletal traction of calca- neus,internal fixative operation with general steel plate or Kirschner wire,or internal fixative operation with special- shaped plate.Results All the cases were followed up for 6 months to 2 years postoperatively.The rate of being ex- cellent and fine of 3 groups treated by 3 different methods was 42%,61% and 72 % separately.Conclusion Inter- nal fixative operation with special-shaped plate is a good way to treat Pilon fracture for its less complication and more recuperation and retention of function for anklebone.

Objective To study the prognostic value of initial arterial lactate level and to explore the relationship between early arterial lactate and the outcome of patients with acute paraquat poisoning by analyzing the clinical data of 235 cases.Methods A total of 235 patients with acute paraquat poisoning were admitted to the Emergency Intensive Care Unit (EICU) from January 2009 to June 2012.Demographics,clinical and laboratory findings were compared between the survivors and non-survivors.Receiver operating characteristic (ROC) curves were used to identify the optimal cut-off points for initial arterial lactate level.Results Totally 235 patients with average age of (33.6 ± 11.5) years old (ranging from 18 to 74),89 male and 146 female.The median estimated amount of 20％ paraquat ingested was 55 mL,(ranging from 10 to 280,IQR:27 mL,77 mL),the median length of time between paraquat ingestion and the arrival at the emergency department was 4.5 h (ranging from 0.5 to 10.5,IQR:2.3 h,6.8 h).The overall mortality rate was 74.0％ (174/235) during a 28 days follow-up period,only 61 of 235 patients survived.The initial arterial lactate level was higher in non-survivors than that in survivors (2.79 ± 0.76) mmol/L vs.(1.62 ± 0.48) mmol/L,P =0.028).Correlation analyses showed that the initial arterial lactate level was associated with increased risk of 28-day mortality (r =0.26,P =0.004),and as the initial lactate increased,the survival time of non-survivors shortened (F =3.246,P =0.037).Using the ROC curve analysis,the initial arterial lactate level had an area of 0.799 (95％ CI:0.745-0.866) and the cut-off point of concentration was 2.57 mmol/L for prediction of prognosis in patients with acute paraquat poisoning (sensitivity 85.2％,specificity 79.6％,the best Youden index was 0.648).The initial arterial lactate level was higher in patients died from circulatory failure rather than from respiratory failure (5.22 ± 1.46) mmol/L vs.(1.87 ± 0.62) mmol/L,P =0.042.And the survival time of patients died from circulatory failure was shorter than that from respiratory failure (4.1 ± 1.3) d vs.(11.6 ± 3.2)d,P =0.023.With the ROC curve analysis,the initial arterial lactate level had an area of 0.882 (95％ CI:0.805-0.941) and the cut-off point of concentration was 3.65 mmol/L for prediction of prognosis of patients died from circulatory failure (sensitivity 87.6％,specificity 82.5％,the best Youden index was 0.701).Conclusions The initial arterial lactate level may be one of early indicators of prognosis in patients with acute paraquat poisoning and it had high potential in predicting the outcome of patients died from circulatory failure.

Objective To investigate the clinical factors dominant in the efficacy of lung recruitment maneuver (RM) with high-level positive end-expiratory pressure (PEEP) under pressure control ventilation in patients with 2009 influenza A (H1N1)-associated acute respiratory distress syndrome (ARDS) by analyzing the clinical data of 24 patients treated with mechanical ventilation.Methods A retrospective study was carried out in a 16-bed capacity emergency intensive care unit (EICU) of the First Affiliated Hospital of China Medical University from October 2009 to January 2010.Twenty-four patients with influenza-associated ARDS were included.During pressure control ventilation,when SpO2 persisted lower than 88％ for more than 30 min,RM with high-level PEEP was initiated to normalize lung volume at 30 cmH2O for 60 s.The RM was responded as SpO2 increased more than 3％ within 15 min; otherwise,the increase below 3％ in SpO2 would be considered non-responded.Variations in respiratory mechanics,oxygen metabolism and hemodynamic parameters were measured before and after RM.Results Of 24 patients with influenza-associated ARDS,16 survived and 8 deceased.The median duration of mechanical ventilation (DMV) in EICU was 5.5 days (range from 3.5 to 12.0 days).During the entire study period,a total of 158 RMs with high-level PEEP were done,including 76 (48.1％) responded RMs (the responded group) and 82 (51.9％) non-responded RMs (the non-responded group).In survivor group,the ratio of effective RM was higher than in nonsurvivors group (66.2％ vs.33.3％,P ＜ 0.01).Compared with the data before RM,HR was increased (92.6 ± 11.8) vs.(73.0 ± 12.6),P =0.038 and MAP was decreased (66.1 ±9.3) mmHg vs.(73.9 ± 11.4) mmHg,P=0.049 during RM,and these difference were not statistically significant at 3 min after RM.The decrease in SpO2 after 134 procedures of RMs in 85.9％ patients,and the minimum value of SpO2 occurred at (2.1 ±0.6) min after RM.In the responded group,the maximum SpO2 were higher than that before RM by (6.9 ± 1.6) ％ occurred at (12.7 ±2.6) min after RM.Compared with the data before RM,SpO2 were increased (90.4 ± 4.4) ％ vs.(86.7 ± 7.6) ％,P =0.047) in responded group at 30 min after RM.The initial PEEP level in the responded group was lower than that of the non-responded group (8.6 ± 3.4) cmH2O vs.(11.3 ±4.2) cmH2O,P=0.028.The initial mean DMV in the responded group was also shorter than that in the non-responded group (4.1 ± 3.1) d vs.(5.8 ± 2.5) d,P =0.011.Furthermore,the initial dynamic lung-thorax compliance (Cdyn) was obviously higher in the responded group than that in the non-responded group (30.8 ±6.2) mL/cmH2O vs.(26.1 ±5.1) mL/cmH2O,P=0.038.Conclusion The lung RM with high-level PEEP may cause temporary hemodynamic changes and the initial PEEP level,DMV,and Cdyn may be potential factors influencing the efficacy of lung RM.

Objective:To observe the changes of visual evoked potential(VEP)in diabetic rats and the influence of nerve growth factor(NGF)and aminoguanidine(AG)on VEP.Methods:Diabetes was induced in adult male Wistar rats with streptozotocin(STZ).Rats were divided into normal control group(CON),diabetes model group(DM).NGF-treated group(D +N)and AG-treated group(D+A).VEP was measured during the 3~(rd)month,6~(th)month,9~(th)month,and 12~(th)month.Results: Compared with the CON group,all rest groups had longer latencies and lower amplitudes(P

Adult ; Female ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Translocation, Genetic

Background The special pathological change of diabetic retinopathy(DR)is microvascular disorder.Angiopoietin-like protein 2(Ang-2)is a new protein associated with genesis of blood vessels.Quercetin has multiple pharmacological action,including improving the microcircularion and the permeability of blood capillary.However,the action mechanism of Ang-2 on DR was unclear.Objective The present study was to investigate the effects of quercetin on Ang-2 and its receptor Tie2 expression in retina with diabetes mellitus.Methods Sixty clean male Wistar rats were randomized into 7 groups and 10 rats for each group,and 10 rats served as blank control group.Streptozotocin of 35 mg/kg was intraperitoneally injected in 60 rats to establish the diabetic models.Quercetins encapsulated by liposome with the doses of 50,150 and 250 mg/(kg · d)(3-5 ml)were used to gavage in different groups of models for 12 weeks,and normal saline solution and calcium dobesilate were used at the same fashion as the negative control group and positive control group,respectively.Twelve weeks later,the animals were sacrificed and retinas were isolated.Expressions of Ang-2 protein and Tie2 mRNA in retinas were detected by ELISA and RT-PCR,respectively.The usage and rearing of the animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Sciences and Technology Commission.Results ELISA showed that the A450 of Ang-2 in 150 and 250 mg/(kg · d)quercetin groups was 0.796±0.057 and 0.842±0.043 respectively and was lower than that negative group(1.012±0.046),showing statistically significant differences(q =2.95,2.698,P＜0.05).RT-PCR assay showed that expression of Tie2 mRNA(Tie2 mRNA/GAPDH mRNA)in retinas was 0.712±0.092 and 0.821±0.087,presenting statistically significant differences in comparison with negative group(1.182±0.098)(q =3.497,2.852,P＜0.05).The expression levels of Ang-2 and Tie2 mRNA in retina were lowest in 150 mg/(kg · d)quercetin group.Conclusions Quercetin can improve the retinal microcirculation by downregulating the expressions of Ang-2 and its receptor in early period of diabetic rats.

This paper reported a new method of Armillaria mellea isolation-Gastrodia elata tissue isolating. Compared with normal isolating method-rhizomorph isolating method, it showed that the success rate of new method (78% ) was higher than the rhizomorph isolating method (16% ) , besides this, the new method was easier, and growth characteristic of obtained strain was superior to that obtained from rhizomorph isolating method.

Myopia is the most important cause of visual impairment in adolescents. However, its etiology is complex. In recent years, a large number of epidemiological studies have been done on risk factors of myopia. Most of these studies is cross- sectional study, not longitudinal cohort study. Overall, the incidence of myopia is the result of the interaction between genetic susceptibility and environmental exposure. This review is about the risk factors for myopia.