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Objective To compare patellar ring,Kirschner wire tension band and patellar ring plus Kirschner wire in fixation for treatment of patella fractures.Methods A retrospective analysis was conducted on the 285 patients with patellar fracture who had been treated between September 2009 and January 2016.They were 155 men and 130 women,with an average age of 45.5 years (from 18 to 70 years).Their fractures included 176 transverse,28 longitudinal split and 81 comminuted ones.They were divided into 3 groups according to their different internal fixation methods:patellar ring fixation (98 cases),Kirschner wire tension band (92 cases),patellar ring plus Kirschner wire fixation (95 cases).The 3 groups were compared in terms of operative time,intraoperative bleeding,fracture healing time,knee function by B(o)stman score at the last follow-up and postoperative complications.Results The operative time in the patellar ring group(58.9 ±6.4 min) was significantly shorter than in the Kirschner wire group (71.8 ± 7.8 min) and in the patellar ring plus Kirschner wire group (74.4 ± 8.0 min) (P ＜ 0.05).There were no statistical significant differences between the 3 groups in fracture healing time and intraoperative bleeding (P ＞ 0.05).The good to excellent rate of knee function at the last follow-up in the Kirschner wire tension band group was 100.0％ (92/92),significantly higher than in the patellar ring group (90.8％,89/98) and in the patellar ring plus Kirschner wire group (91.6％,87/95) (P ＜ 0.017).There was no significant difference in postoperative complication rate between the patellar ring fixation group (2.0％,2/98),Kirschner wire tension band fixation group (1.1％,1/92) and the patellar ring plus Kirschner wire group (2.1％,2/95) (P ＞ 0.05).Conclusion Internal fixation with Kirschner wire tension band has definite curative effect on patellar fractures,showing the advantages of less operative invasion,fewer postoperative complications,better functional recovery of the affected knee joint,and lower price over the other 2 internal fixation methods.

ObjectiveTo study the reasons and mechanism of cardiomyocyte apoptosis in chronic heart failure by using Losartan and to provide a theoretical basis for the treatment of chronic heart failure. Methods The models of chronic heart failure were produced by injecting Adriamycin and Losartan as intervention agents, the expression of apoptotic protein Bax, Bcl-2 and channel protein ERK1, JNK1 and P38MAPK were detected by immunohistochemistry and RT-PCR.Cardiomyocyte apoptosis and myocardial ultrastructure are detected by transmission electron microscopy and TUNEL staining.Results Compared with the model group of heart failure, after Losartan treatment, the ultra structure of myocardial cells were significantly improved, Apoptosis index was decreased significantly (P <0.01), The level of Bax and JNK1 decreased (Bax χ~2=6.6149, P=0.0078; JNK1 q=22.0156,P<0.01). However, the expressions of ERK1 and Bcl-2 were significantly increased (ERK1 q=15.3514,P<0.01;Bcl-2 χ~2=6.81,P=0.0074).Conclusion The effect of Losartan on chronic heart failure is related closely with the pathway of ERK1 and JNK1, and no p38 MAPK pathway.

OBJECTIVE: To find out some evidence that may indicate the theory of voice pitch of the five tones being correlated with the five zang viscera in Huangdi Neijing, which was lost 2 000 years. METHODS: Eight-four healthy females were divided into younger group (<34 years old) and older group (> or =34 years old) according to their ages. The pronunciations of these females were examined by sono-frequency analysis facility. RESULTS: The frequency of Jiao tone was much higher than those of the other tones in both groups (P<0.01) and the frequency of Jiao tone increased as aging. The frequency of Zhi tone in the younger group was higher than that in the older group (P<0.05). CONCLUSION: The results of higher frequency of Jiao tone in females is in accordance with the theory put forward by Ye Gui (a famous doctor in Qing Dynasty of China) that the liver is the congenital base of female life. In traditional Chinese medicine, Jiao tone is correlated with the liver, and Zhi tone is correlated with the heart. The high frequency of Zhi tone in younger females implies that regulating the Small Intestine Meridian of Hand-Taiyang and Heart Meridian of Hand-Shaoyin may be beneficial to the health maintenance of younger female.

Objective To study the effects of carotid sympathectomy on symptom or intercurrent damage of refractory cerebral palsy.Methods 204 cases with cerebral palsy of mixed type and with intercurrent damage were treated with bilateral carotid sympathectomy.Results 187 cases(91.7%) were followed up successfully,which showed 74.4% of torsion or tension spasm,42% of athetosis,63.6% of cognition language disturbance,81.6% of sialorrhoea,27.6% of strabismus and 88% of deglutition handicap improved.The scores of activity of daily living improved 43.8%.The total incidents effective rate was 82.7%.Conclusion Carotid sympathectomy is an effective and safe microsurgery method for the symptom or intercurrent damage of the refractory cerebral palsy.

ObjectiveTo compare the clinical effect of percutaneous iliosacral screws osteosynthesis (PISO) and open reduction internal reconstruction plate fixation in treating unstable pelvic fractures combined with sacroiliac joint dislocation,and evaluate their safety and practicality.MethodsFrom March 2004 to October 2010,37 patients with vertical unstable pelvic fractures were admitted to our department.Twenty cases were treated with percutaneous sacroiliac screw fixation and 17 cases were performed opened reduction and internal reconstruction plate fixation under C-arm X-ray's guide.The perioperative parameters and postoperative imaging indexes were compared and analyzed.ResultsAll patients were followed up for 6 months to 26 months,with an average of 15 months.There were statistical significances between the PISO group and open reduction internal fixation group in operation time,blood loss,postoperative pain,mean fever time and hospital stay.The two groups showed no significant difference on postoperative X-evaluation of reduction effect.The average healing time was 3.2 months and the difference was not statistically significant between two groups.PISO group had no complications such as infection,bent nails or broken nails.ConclusionThrough compared and analyzed the two groups in treating unstable pelvic fractures,the percutaneous sacroiliac screw fixation has been proved for a kind of ideal minimally invasive surgery method because of locating exactly,less damage and blood loss,milder pain and quicker recovery.But it demands higher operation techniques.Adequate preoperative preparation and postoperative patients' cooperation can reduce complications incidence.The second group of anterior reconstruction plate or T-shape plate to fix vertically unstable pelvic fractures at same time shows a good result of stabilization.

BACKGROUND: Fibronectin(FN) plays the role of repair in the inflammation. There is no confirmed conclusion whether it can be applied to the refractory corneal epithelial defect.OBJECTIVE: To observe the repair effect of the human plasma FN for the refractory corneal epithelial defect.DESIGN: A controlled experimental study.SETTING: Guangzhou Red Cross Hospital, Guangzhou First People's Hospital, Guangzhou Children's Hospital, Guangzhou Hospital of Traditional Chinese Medicine and Guangzhou Second People's Hos pital.PARTICIPANTS: Totally 383 eyes with the refractory corneal epithelial defect were chosen, of which 309 were in the therapy group, and 74 in the control group.METHODS: The therapy group: Human plasma FN was administered by dropping it into the eyes once every two hours. The controlgroup: 10 g/L celacol M was administered by its dribbling into the eyes once every two hours. Weilesheng was taken orally in both groups, two pills once, three times per day. According to the state of illness, both groups received anti-bacterial or anti-viral treatment and reexamination was given every day or every other day after administration. 10 g/L fluorescein sodium was used to observe the changes of cornea.MAIN OUTCOSE MEASURES: The symptoms, results of staining using fluorescein sodium as well as the corneal epithelial healing of both groups.RESULTS: The symptoms, the results from staining using the fluorescein sodium and the corneal epithelial healing were used for the evaluation. In the therapy group, 309 eyes were followed up and the cure rate was 69.9%. The average therapeutic period was 6.5 days, while those of the control group were 58.1% and 8.7 days respectively. The difference in the curative effect between the two groups was significantly different( P＜0.01 ).CONCLUSION: The application of FN for the refractory corneal epithelial defect displays a more significant effect than conventional treatment.

Objective:To evaluate an anticoagulation management method based on mobile health technology and artificial intelligence.Methods:The study was a single-center, prospective, randomized, controlled, non-inferiority clinical trial. From November 2017 to September 2018, 67 patients who received warfarin therapy after mechanical valve replacement were consecutively enrolled and randomized into two groups: 34 were randomized to intervention group and 33 to control group. The intervention group was managed via Anticlot Assistant and the control group was handled as routine care. Evaluations were performed at least 3 months after enrollment and ended on 30 September 2019. Non-inferiority was evaluated using one-sided tests with a non-inferiority margin set 11.0% for time in therapeutic range (TTR) and 10.0% for the percentage of international normalized ratio (INR) in the therapeutic range.Results:The mean TTR was (58.2±23.4)% in the intervention group and (54.8±23.6)% in the control (the difference: 3.4%; low limit of one-side 95% confidence interval for the difference: -6.4%; and P value for non-inferiority was 0.009). The percentage of INR in the therapeutic range was (55.4±21.9)% in the intervention group and (52.8±22.5)% in the control (the difference: 2.6%, low limit of one-side 95% confidence interval for the difference: -6.6%; and P value for non-inferiority was 0.012). Conclusion:The outcomes of patients managed via the anticoagulation management method base on mobile health technology and artificial intelligence are not inferior to those handled as routine care.

Objective    To verify the reliability of Anticlot Assistant, a patient self-management system for warfarin therapy assisted by artificial intelligence. Methods    It was a single-center, prospective cohort study. The eligible 34 participants were recruited consecutively between November 29, 2017 to September 27, 2018 and managed by warfarin therapy via Anticlot Assistant. The recommendations of Anticlot Assistant were examined and verified by the doctors to ensure the security. Medical records were exported from the the background management system. An univariate analysis compared the outcomes between accepted and overridden records and a logistic regression model was built to determine independent predictors of the outcomes. The research team analyzed 153 medical records, which were from 18 participants and were input by 19 doctors. There were 97 records with doctor accepting the suggestion and 56 records with doctor rejecting the suggestion . Results    When the doctors accepted the recommendations, the percentage of the next-test international normalized ratio (INR) in the therapeutic range was higher (64.95% vs. 44.64%, RR=2.298, 95%CI 1.173 to 4.499, P=0.014). The logistic regression analysis revealed that accepting the recommendations was an independent predictor for the next-test INR being in the therapeutic range after controlling potentially confounding factors (OR=2.446, 95%CI 1.103 to 5.423, P=0.028). Conclusion    The algorithm of Anticlot Assistant is reasonable and reliable.

Polylactic-co-glycolic acid (PLGA) has the characteristics of biocompatibility, biodegradability, modifiability, and slow release, which has attracted extensive attention in the treatment of gynecological diseases. This paper summarizes the relevant literature reports at home and abroad in recent years, expounds the research situation of PLGA nanoparticles as drug carriers in gynecological diseases such as ovarian cancer, breast cancer, cervical cancer and endometriosis, and looks forward to its great potential in clinical application in gynecological diseases, providing guidance for its prevention and treatment in gynecological diseases.