[Objective]To explore clinical effect of DHS combined with hollow traction bolt treating thighbone interrotor fracture. [Method]From May 2003 to July 2006,apply DHS combined with hollow traction holt to treat thighbone interrotor fracture 9 ca- ses,6 males,3 females,aged 47～72,62.6 in average,5 cases of left side,4 right side;classify under Evan's:5 cases of typeⅡ, 2 ofⅢ,2 ofⅣ.[Result]Follow up for 6～21 months,12 months in average.Appraise the clinical effect by Huang Gongyi's standard,7 cases were very good,1 good,1 bad,the good rate was 89%.[Conclusion]DHS combined with hollow traction bolt treating thighbone interrotor fracture can obviously increase stability of fracture point,reduce local rotation,helpful to fracture cure and early exercise,as well as the complication.

Objective To evaluate the diagnostic value of multi-slice spiral CT (MSCT)for traumatic spleen and liver rupture.Methods We made a retrospective analysis of 140 cases of liver and spleen injury with clinical manifestations confirmed by operation.MSCT examination results and clinical data were compared.Results Of the 140 cases,male patients outnumbered female ones,and the peak age was 10 - 30 years old.The injuries were most commonly attributed to traffic accident and falling.There were 69 (49%)cases of spleen injury,5 1 (36%) cases of liver injury,and 20 (14%)cases of both.Liver and spleen injuries showed on MSCT examination were liver and spleen laceration, hematoma within the liver and spleen as well as hematoma beneath the envelop. Conclusion MSCT has an important diagnostic value for traumatic liver and spleen rupture and thus can guide clinical treatment choice.

Objective To assess the clinical application value of phleboplasties combined with microvascular anastomotic device in venous anastomosis with diameter discrepancy in head and neck defects reconstruction.Methods Sixty-six pairs of veins with significant diameter discrepancy were anastomosed in head and neck reconstructive surgeries with free flaps.Forty of them were anastomosed with microvascular anastomotic device (the coupler group) after phleboplasties including lateral incision, Y-T enlargement and wedge excision while the other 26 pairs of veins were conventionally sutured (the sutured group).Diameter of each vein, anastomosis time, post-operative vascular crisis, flap survival and complications related to the microvascular anastomotic device were recorded.Results The average anastomosis time of the coupler group was (4.78 ± 1.14) min for lateral incision, (5.16 ± 2.07) min for Y-T enlargement and (11.09 ± 3.21) min for wedge excision, and all of them were significantly shorter than that of the sutured group.In the sutured group, all flaps survived except for 2 veins with poor blood flow were cut and re-anastomosed during the operation;1 flap with venous crisis within 72 hours after the operations was explored and replaced with the pectoralis major myocutaneous flap.All veins in the coupler group were successfully anastomosed in a single coupling procedure without anastomotic impatency, blood leak, vessel tearing and ring shedding.No vascular crisis occurred postoperatively.One patient underwent cervical haematoma 5 hours after the operation, and the flap blood supply was unaffected after the haematoma was removed.All flaps in the coupler group survived completely.Patients in both two groups were followed up 6 to 18 months.All flaps healed perfectly and no obvious surgical complications or microvascular anastomotic device rejection happened.Conclusion When anastomoses are carried out using microvascular anastomotic device between veins of different size, phleboplasties including lateral incision., Y-T enlargement and wedge excision can not only reduce the size discrepancy and the anastomosis time, but also ease the difficulty level and guarantee the patency of the venous anastomoses.Wedge excision enjoys the advantage of haemodynamics, and obstruction of venous reflux hardly occurred for size reduction.It should be considered preferentially when external jugular veins are used as the anastomotic vein of the recipient sites in head and neck reconstruction.

Objective To explore the difference in ocular biologically effective ultraviolet irradiance in two areas with different altitudes ,Xichang and Shaoxing,and provide a reference basis for ocular UV protection. Methods A self?designed rotating mannequin and dual?detector spectrome?ter were used to monitor the intensity of ocular exposure to UV irradiation under clear skies in Xichang and Shaoxing. Monitoring data were pro?cessed and analyzed with AvaSoft 7.4 USB2 software and OriginPro 8.0 software. Results The diurnal variations of ocular biologically effective ul?traviolet irradiance exhibited bimodal distribution in Xichang and Shaoxing. The maximum UVBEcorn,UVBEconj,and UVBElens of Xichang were about 1.7 times,2 times,and 1.8 times that of Shaoxing,respectively. Under the same solar elevation angle,the biologically effective ultraviolet irra?diance of the cornea,conjunctiva,and lens in Xichang were higher than those of Shaoxing. Conclusion The diurnal variations of ocular biologi?cally effective ultraviolet irradiance exhibit bimodal distribution in areas at two different altitudes. Under the same solar elevation angle ,the biologi?cally effective ultraviolet irradiance of the cornea,conjunctiva,and lens of Xichang are significantly higher than those of Shaoxing.

Objective:To explore the mechanism of circular permuted tumor necrosis factor-related apoptosis-inducing ligand (CPT) reversing the resistance to imatinib in chronic myeloid leukemia (CML) cells.Methods:Five patients with CML in the Affiliated Hospital of Inner Mongolia Medical University from 2016 to 2020 were selected, and heparinized bone marrow blood samples were collected at the first diagnosis and imatinib resistance phase, and mononuclear cells were isolated. The mononuclear cells collected at the first diagnosis were named A1-E1, and the mononuclear cells collected after imatinib resistance were named A2-E2. Human CML wild-type K562 cell line (K562-W) was given gradually increasing small doses of low-concentration imatinib to obtain imatinib-resistant K562 cells (K562-R). K562-R cells were cultured with 20 μg/L CPT and these cells were set as CPT-K562-R group. The CCK-8 method was used to detect the half inhibitory concentration ( IC50) of cells for imatinib. K562-W and K562-R cells were used to establish CML xenografts nude mice models, then the nude mice were divided into K562-W, K562-R and CPT-K562-R xenograft groups. Imatinib was perfused orally in all three groups, and CPT was injected subcutaneously in the CPT-K562-R group at the same time. The tumor volume of the three groups of nude mice before and 4 weeks after treatment with imatinib, and the survival time of the three groups of nude mice were compared. Western blot was used to detect the changes of tyrosine protein kinase receptor B4 (EphB4) and myeloid cell leukemia protein 1 (Mcl-1) protein levels in bone marrow mononuclear cells, K562 cell line and transplanted tumor tissues of CML patients. Results:The expressions of EphB4 protein in A2-E2 cells of 5 patients with CML were higher than those in A1-E1 cells (all P < 0.01). The IC50 of K562-W, K562-R and CPT-K562-R cells for imatinib were (0.160±0.015) mg/L, (5.450±0.460) mg/L, (0.300±0.035) mg/L, and the difference was statistically significant ( F = 390.65, P < 0.01). In cells of K562-W group, EphB4 and Mcl-1 proteins were expressed at low levels (0.54±0.02 and 0.70±0.08); in cells of K562-R group, the expressions of EphB4 and Mcl-1 proteins were enhanced (3.04±0.11 and 2.88±0.04); in cells of CPT-K562-R group, the expressions of EphB4 and Mcl-1 proteins decreased (0.57±0.03 and 0.38±0.04). Before imatinib treatment, there was no statistically significant difference in the tumor volumes of nude mice among the K562-W, K562-R and CPT-K562-R xenograft groups ( F = 0.39, P = 0.68), suggesting the transplanted tumors formed in nude mice were balanced; after imatinib treatment, the difference in the tumor volumes among the three groups were statistically significant ( F = 26.16, P < 0.01). The survival time of nude mice in the K562-W, K562-R and CPT-K562-R xenograft groups was (18.5±3.3) d, (10.0±2.4) d and (17.5±1.6) d, and the difference was statistically significant ( F = 20.45, P < 0.01). In K562-W xenograft group, both EphB4 and Mcl-1 proteins were expressed at low levels (0.55±0.06 and 0.67±0.06); in K562-R xenograft group, the expressions of EphB4 and Mcl-1 proteins were enhanced (1.95±0.08 and 6.21±0.53); the expressions of EphB4 and Mcl-1 in CPT-K562-R xenograft group decreased (0.59±0.04 and 0.37±0.04) and were close to their expressions in K562-W xenograft group. Conclusion:CPT may enhance the sensitivity of CML to imatinib by inhibiting the expressions of EphB4 and Mcl-1, and this may be a targeted pathway for imatinib therapy.

OBJECTIVE: To study the health service development in Hunan Province, and to find out the advantages and disadvantages, and to make tentative specific suggestions. METHODS: Comparison was made in Yunnan, Hunan, and Zhejiang Provinces in 4 major areas: health institutions, personnels, facilities, and funding. RESULTS: The overall health service of Hunan Province was good: The health resources increased, the allocations were reasonable, and the health expenditure decreased. Some problems appeared, such as backward primary health, shortage of medical talents, inefficient use of hospital beds, deducted government investment, increased business income, and large urban-rural gap. CONCLUSION There is urgent need to further develop health institutions and increase personnels, particularly improving the primary health care and making use of traditional Chinese medicine; improving the management of hospital beds to increase efficiency, increasing financial support to reduce the patients' burden, and ensuring the need of rural health care.
China ; Delivery of Health Care ; trends ; Health Services ; economics ; statistics & numerical data ; Health Services Administration ; Humans ; Rural Health ; economics

Objective:To investigate the value of 3D printing combined with intraoperative electrophysiological monitoring in excision of cerebellopontine angle (CPA) tumor.Methods:The clinical data of 43 patients with CPA tumor, admitted to our hospital from October 2016 to October 2019, were collected and analyzed. These patients were voluntarily divided into ordinary group ( n=27) and optimized group ( n=16). Patients in the ordinary group were operated microscopically, and those in the optimized group were operated microscopically with 3D printing combined with intraoperative electrophysiological monitoring. The degrees of tumor resection and neurological functions (facial and auditory nerve function, swallowing function, limb activity) improvements were compared between the two groups. Results:The degrees of tumor resection of the optimized group were significantly higher than those of the ordinary group ( P<0.05), and the improvement of facial and auditory nerve function in the optimized group was significantly better than that in the ordinary group ( P<0.05). There was no significant difference in improvements of swallowing function and limb activity between the two groups ( P>0.05). Conclusion:The 3D printing combined with intraoperative electrophysiological monitoring can improve the resection rate of CPA tumor, protect the facial auditory nerve, and improve the quality of life of patients after surgery.

Objective:To construct a practical education training quality evaluation system that can monitor the entire training process for the master of public health, and to provide a basis for improving the public health education system.Methods:Based on the survey of the current status of the master of public health, combined with the literature survey, the focus group discussion and the expert forum, an evaluation system was established, and the weight coefficient of each index was determined by the analytic hierarchy process (AHP). All data were entered by Excel double-person, and matlabR2018a was used to calculate the weight, and determine the maximum characteristic root of the matrix, consistency index and consistency ratio.Results:The evaluation index system consisted of 7 first-level indicators and 24 second-level indicators. The average authority coefficient of 32 experts was 0.791. The top three items with the highest weight in the first-level indicators were mentor guidance (0.213), professional practice (0.157) and scientific research topics (0.149). The weight coefficient consistency ratio ( CR) was 0.040, showing that the consistency test passed ( CR<0.1). Conclusion:The educational quality evaluation system of the master of public health constructed by the institute is scientific, and the weight of the evaluation index reflects the focus of the postgraduate training process of the master of public health, which can provide a reference for improving the quality of public health professionals.

Blood-brain barrier (BBB) damage after ischemia significantly influences stroke outcome. Compound LFHP-1c was previously discovered with neuroprotective role in stroke model, but its mechanism of action on protection of BBB disruption after stroke remains unknown. Here, we show that LFHP-1c, as a direct PGAM5 inhibitor, prevented BBB disruption after transient middle cerebral artery occlusion (tMCAO) in rats. Mechanistically, LFHP-1c binding with endothelial PGAM5 not only inhibited the PGAM5 phosphatase activity, but also reduced the interaction of PGAM5 with NRF2, which facilitated nuclear translocation of NRF2 to prevent BBB disruption from ischemia. Furthermore, LFHP-1c administration by targeting PGAM5 shows a trend toward reduced infarct volume, brain edema and neurological deficits in nonhuman primate