[Objective]To evaluate the clinical effect of the plastic splint on treatment of Colles fracture.[Method]A total of 105 patients with Colles fracture were collected between September 2002 and August 2008.All patients were perfromed using the plastic splint afrer diaplasis.According to Gartland and Werley scoring syste,the function of wrist was evaluated after 3 months.[Result]There are only 2 cases losing during treatment,103 cases were finished.The average excellent to good case was 90.3%,including 80 cases of being excellent,13 of being good,7 of being fair and 3 of being poor.[Conclusion]The plastic splint is exactly effective to treatment Colles fracture,especially,it could effectively relieve swelling and improve the contour of the wrists.Theses all rely on reasonable biomechanics design.

Objective To explore the causes,clinical manifestations,diagnosis and treatment method of femoral artery pseudoaneurysms (IFPSA) after ultrasound-guided percutaneous coronary intervention.Methods Ultrasound-guided repair by compression was applied to all cases,of which the failed cases were treated with ultrasound-guided thrombin injection.Results IFPSA was confirmed by ultrasound imaging in 39 cases,18 of which were cured by compression repair,with the average compression duration of (36.78 ± 1.71 )min.Another 21 cases were cured by the thrombin injection,after compression repair failed,with average time for thrombosis (0.33 ± 0.06 )min.All the patients were re-evaluated by ultrasound 24 h after treatment,confirming the successful closure of the pseudoaneurysms.No recurrence of pseudoaneurysm was observed during a half-year post-operative follow-up.Conclusion Ultrasound-guided compression repair and ultrasound-guided thrombin injection into the cavity are safe and effective treatments for femoral arterial pseudoaneurysms after coronary intervention.

Objective To evaluate the operative technique, perioperative management and outcomes of bilateral lung transplantation for idiopathic pulmonary artery hypertension. Methods There were 2 cases of idiopathic pulmonary hypertension subject to bilateral sequential lung transplantation with ECMO support (16, 17 years old, respectively). The pulmonary artery pressure was 10/70 and 148/72 mm Hg respectively. The heart function was NYHA Ⅳ, the operative procedure was right lung first, then left lung, and the cold ischemia time was 230 min/430 min and 185 min/300 min respectively. The ECMO support time was 550 min and 450 min respectively. The blood loss during the operation was 3000 and 1200 ml, respectively. Resuits The ECMO was withdrawn 16 and 13 h postoperation respectively. There was unstable hemadynamics and acute left heart failure on the 3rd and 4th day after the operation. The patients were treated with ventilate support and tracheotomy on 3rd and 6th day respectively. Additionally, the patients were given cardiotonic, dieresis and the ventilation was withdrawn on 33rd and 12th day after the operation respectively. They were discharged from the hospital on 93rd and 32nd day after the operation. The heart function both reached NYHA I, two cases were followed up for 25 and 10 months respectively.Both of them had an excellent quality life. Conclusion Bilateral lung transplantation is effective for end-stage idiopathic pulmonary artery hypertension even with slight right ventricular dysfunction with satisfactory short-term outcome. A limited operative time, an ECMO support for heart and lung during the peri-operative period and a perfect management for the left ventricular dysfunction after surgery are key roles for the success. Closed follow-up and surveillance are needed for long-term outcomes.

Objective To explore the effect of experimental design in the experimental teaching of fundamental nursing. Methods 168 and 199 baccalaureate nursing students were in the control and experimental group respectively, the control group received traditional experimental teaching method, and the experimental group must complete the experimental design before entering the lab. The teaching effect between the two groups were compared. Results The mean operation score of the experimental group was significantly higher than the control group, the proportion of those students who reflected their teaching method could enhance creative ability, problem-solving ability and practical ability was higher in the experimental group, 100% teachers reflected experimental design could improve operation level, strengthen theoretical knowledge, animate teaching atmosphere. Conclusions Experimental design could arouse students' enthusiasm and initiative to study, advocate them to think and ask.

ObjectiveToobserve the regulating effect of acupuncture at Fengchi (GB20) and extraordinary points on tumor necrosis factor (TNF)-aand endothelin (ET) in hypertension.MethodTotally 150 patients with hypertension were randomized into two groups at a ratio of 1:1.In the control group, 75 subjects were intervened by acupuncture at bilateral Fengchi; in the treatment group, 75 subjects were intervened by acupuncture at bilateral Fengchi plus extraordinary points. The needles were manipulated once every 10 min duringthe 30-min session. The treatment was given once per day, 2 weeks as a treatment course. ResultDuring the intervention, the TNF-aand ET contents were decreased significantly in the treatment group (P<0.05); the TNF-aand ET contents were also decreased in the control group but without statistical significance (P>0.05). After 1 treatment course, the TNF-aand ET contents were decreased significantly in the treatment group (P<0.05); the TNF-aand ET contents were insignificantly decreased in the control group (P>0.05); there was a significant difference in comparing the TNF-aand ET contents between the two groups (P<0.05). There were also significant differences in comparing the TNF-aand ET contents inhypertension of various degrees between the two groups (P<0.01). The results showed that the TNF-aand ET contents in patients intervened by acupuncture at Fengchiand extraordinary points were lower than that in those intervened by acupuncture at Fengchialone, i.e. combination of Fengchi and extraordinary points produces a significant effect on regulating TNF-aand ET contents.Conclusion Acupuncture at Fengchi and extraordinary points can produce a more significant effect than acupuncture at Fengchi alone on regulating TNF-aand ET in patients with hypertension.

Clinical evaluation proceedings from patient-reported outcomes (PRO) are being concerned increasingly. Based on the concept of PRO, the report discusses the findings in the research recently made at home and abroad. PRO from apoplexy patients with spastic paralysis was taken as an example in the exploration of how to evaluate the curative effects in clinical practice on the basis of PRO.

Objective To investigate the clinical application of pulse indicator continuous cardiac output (PICCO) target oriented role monitoring technique on hemodynamics in patients with intractable heart failure.Methods Eighteen patients with intractable heart failure were selected as control group and received regular treatment including internal medicine under monitoring by central venous pressure.Another 18 patients with refractory heart failure were selected as PICCO group and given the internal medicine under PICCO monitoring.Intrathoracic blood volume index(ITBVI),global end diastolic volume index(GEDVI),extravascular lung water index (EVLWI),cardiac index (CFI),N-terminal B type natriuretic peptide precursor(NT-proBNP) and left ventricular ejection fraction(LVEF) were recorded.The data including mortality rate,ventilation time,intensive care time,APACHE Ⅱ score and the re-hospitalization rate were also record at 28th day.Results Compared with before treatment,ITBVI,GEDVI,EVLWI in PICCO group were (1 282.6 ± 196.4) ml/m2,(1 026.8 ±92.1) ml/m2,(12.9 ± 5.5) ml/kg respectively,significant different from that before treatment ((907.4±78.3) ml/m2,t =8.75,P =0.001; (715.2 ±61.8) ml/m2,t =6.48,P =0.003; (6.5 ± 1.2)ml/kg),t =2.94,P =0.033) and they are all back to normal level.The indices of CFI,NT-proBNP,LVEF in PICCO group were improved than before treatment (CFI:(3.1 ±0.5) L/min vs.(4.8 ± 1.3) L/min,t =2.56,P=0.042) ;NT-proBNP:(6 438.3 ±249.5) ng/L vs.(1 371.6 ±87.5) ng/L,t =5.12,P =0.019) ;LVEF:(26.9±3.1)％ vs.(54.3 ±2.5)％,t =2.62,P =0.040)).Mortality at 28th D in PICCO group was 16.7％,lower than that of control group (33.3％,x2 =4.99,P =0.026).The indices of assisted ventilation time,intensive care time,APACHE score of lⅡ and the rehospitalization ratein PICCO group were better than that of the control group ((8.5 ±2.3) dvs.(3.2±0.8) d,t=24.31,P＜0.05;(14.9±2.3) dvs.(8.3 ±2.0)d,t=12.26,P=0.002;(23.4±1.3) vs.(14.7±1.6),t=9.52,P=0.011;38.9％ vs.11.1％; t=5.79,P =0.020).Conclusion PICCO provides effective guidance for intractable heart failure patients hemodynamic monitoring of goal orientation.

Objective To establish a method for detecting Aspergillus spp.by Loop-mediated isothermal amplification.Methods Aspergillus spp.specific primers were designed from the relative conservation region of the published sequence of 28S rRNA genes of A.fumigatus (GenBank accession number AY660917),A.terreus (GenBank accession number AF454183),A.flavus (GenBank accession number AF454158),and A.niger (GenBank accession number AF454169).Genomic DNA were extracted from Aspergillus standard strains,clinical control strains and clinical samples,and amplified by LAMP.The amplified results could be read with the naked eye by the coloring effect of fluorescent nucleotide dye without the DNA electrophoresis.Approximately 103 each Aspergillus conidia suspension was added to the serum from healthy volunteers,and detected these simulative clinical samples bv LAMP assay.Results The LAMP and PCR assays obtained positive results for all four Aspergillus species and 8 simulative clinical samples (double samples for each Aspergillus species) including 103 conidia,but negative in the remaining 15 non-Aspergillus species,human total blood genomic DNA,30 clinical serum samples infected with non-Aspergillus and 10 healthy volunteers.The LAMP assay had a minimum detection of 0.05-0.5pg,by means of detect different levels of 500,50,5,0.5,0.05 pg template in each reaction tube.Conclusion The results confirm that LAMP is a simple,rapid,sensitive and specific method,and can be used for detection of Aspergillus strains in clinical and environmental specimens.

Peroxisome proliferator-activated receptors (PPARs) are a family of nuclear hormone receptors belonging to the steroid receptor superfamily. Three PPAR isoforms, PPAR?, PPAR? (also known as PPAR?) and PPAR? have been found in the mouse. They can activate expression of many genes, including those involved in lipidmetabolism. PPAR? is ubiquitously expressed, but the level of expression differs markedly between different cell types. PPAR? is expressed in skeletal muscle at 10- and 50-fold higher levels compared with PPAR? and PPAR?, respectively. A role for PPAR? in skeletal muscle is to increase the genes expression with relation to oxidative metabolism. In order to determine the molecular mechanisms governing PPAR? gene expression in muscle, a 2 kb 5′ flanking region was cloned and analyzed. The DNA fragment is able to transcribe GFP in COS7 cells. Dual luciferase assay is used to quantify promoter activity. Deletion analysis of the 2 kb PPAR? promoter fragment in COS7 and NIH 3T3 cells shows that the proximal promoter sequence, nt -197 to +120, confers basal transcriptional activity of the mouse PPAR? gene. Computational analysis of putative cis-acting elements located within the ～2.0 kb mouse PPAR? 5′-flanking sequence was performed using the TRANSFAC database and MatInspector software and 4 potential MEF2A binding sites were found. And there is a potential binding site sharing 100% identity with positive element of MEF2A in the proximal promoter (nt -261). Co-transfection experiments of the PPAR? promoter reporter and pMEF2A expression plasmid (pMEF2A) showed that MEF2A significantly enhanced transcription activity of PPAR? promoter in NIH 3T3. Moreover, the enhancive effect depended on the concentration of plasmid pMEF2A transfected into cells. The results suggested that MEF2A may enhance transcription activity of the PPAR promoter in muscle cells.

Aim To investigate the effects of Ginkgo biloba extract(EGB)on tumor necrosis factor-alpha(TNF-?)in TNBS-induced colitis in rats and its mechanisms.Methods Colitis in rats was induced by colonic administration with 2,4,6-trinitrobenzene sulfonic acid(TNBS).Wistar rats were randomly divided into four groups,10 in each:normal group,model group,5-aminosalicylic acid(5-ASA group)and Ginkgo biloba extract group(EGB group).The levels of nitric oxide(NO),and glutathion peroxide(GSH-Px)were measured by biochemical methods.The expressions of TNF-? and nuclear factor kappaBp65(NF-?Bp65)in the colon tissues of colitis rats were detected by means of immunohistochemistry.The expressions of induce nitric oxide synthase(iNOS)in the colon tissues of colitis rats were detected by reverse transcription polymerase chain reaction(RT-PCR).The effects of EGB on colonic inflammation and macroscopic and histological damage were evaluated as well.Results Compared with the model group,treatment with EGB for 4 weeks significantly reduced colon macroscopic and histological damage,elevated the activities of GSH-Px and reduced the contents of NO,inhibited the protein expressions of TNF-? andNF-?Bp65,and decreased the mRNA levels of iNOS in the colon tissues of experimental colitis.Conclusions The probable mechanisms of EGB was that it ameliorated inflammatory injury in TNBS-induced colitis in rats by its reduction of TNF-?,NF-?Bp65 and iNOS levels.Then EGB could curb the inflammatory cascade effects of inflammatory mediators to protect ulcerative colitis.