Objective To investigate the clinical characteristics and operative treatment of humeral super-middle fracture combined with brachial artery injury. Methods 9 cases of humeral super-middle fracture combined with brachial artery injury have been treated in our department since 2000 with reduction, axial external fixation, and autotransplantation of great saphenous vein to repair brachial artery. Results All patients were followed up for 1 to 2 years. No stenosis occurred at the anastomosed veins and the limbs survived well. All fractures achieved clinical healing except 1 case who had nonunion following refracture and had to undergo secondary operation. Conclusion The operation is simple and easy, but effective in treatment of the humeral super-middle fracture combined with brachial artery injury.

Objective To identify the disease locus in X-linked retinitis pigmentosa (RP) families using genetic linkage analysis. Methods Five microsatellite markers were selected from the RP2, RP3, RP6, RP23 and RP24 gene loci, respectively. Haplotype analysis for two X-linked RP families was performed to determine the critical region. Two-point linkage analysis was performed using MLINK program. Results In FYJ and ZCF X-linked RP families, the LOD score was 1.18 and 1.03 at DXS 993, 0.58 and -2.69 at DXS 1068, -2.33 and -2.45 at DXS 1214, -2.34 and -2.51 at DXS 8051, -2.23 and -2.62 at DXS 8043. Conclusion The phenotype of ZCF family is not caused by mutation of RP3, RP6, RP23, RP24 gene, and FYJ family may be linked to RP2 or RP3 gene.

To investigate the clinical improvement of limping gait in patients with ankylotic hips and limb length discrepancy.Methods:From 1996 to 2005,12 patients with ankylotic hips and limb length discrepancy were treated by distraction osteogenesis with a mono-lateral external fixator and an intramedullary nail.The limb length discrepancy was 6.20-12.50 (median 8.45) cm.Limping gait was classified according to the recommendations of the American Academy of Orthopedic Surgeons/Hip Society and scored according to Harris:no limping scored 11 points,mild limping scored 8 points,moderate limping scored 5 points,while severe limping scored 0 points.Limping gait was severe in all patients pre-operatively and the total score was 0.Results:All patients were followed up for 30.00-46.00 (median 38.55) months,and all reported improvement in limping gait.The gain in length was 6.00-12.50 (median 8.20) cm,and the mean residual limb length discrepancy was 0-0.50 (median 0.20) cm.The total treatment time was 41.00-82.00 (median 61.50) weeks,the lengthening time was 14.00-38.00 (median 29.55) weeks.At the last follow-up,10patients had mild limping gait and 2 had moderate limping gait; the total score was 90.00.The median score was 7.50 (P25 was 8.00,P75 was 8.00).According to Wilcoxon signed rank test,the post-operative limping gait scores were significantly higher than pre-operative (P=0.001 ).Conclusion:Femoral lengthening can improve the limping gait significantly in ankylotic hips and limb length discrepancy.

Objective This study analyzes the effect of the shrinkage of thermoplastic mask on patient positioning. Methods Design of the two test. Test 1:thermoplastic film shrinkage test. Get some thermoplastic film by the size of 10 cm×5 cm, extrude it at a certain rate after heated. Measure the length of thermoplastic film on different time, and calculate the contraction. Test 2:phantom test. Take advantage of head and neck phantom, and simulate the procedure that from making mask for patients to radiation therapy. Measure the off set of isocenter which caused by the contraction of thermoplastic mask. Results The largest shrinkage of thermoplastic had happened in 20 minutes. Different tensile ratio had little effect on the shrinkage. The offset of isocenter which caused by the shrinkage of thermoplastic mask were:LR ( -0?? 1± 0?? 3) mm,SI (-0?? 2±0?? 2) mm, AP (0.6±0?? 4) mm,respectively. There was little change in the course of six weeks ( P= 0.185?0?? 961). Conclusions The cooling time should be more than 20 minutes, when making a mask for the patient. The setup errors which caused by the shrinkage of thermoplastic mask is at an acceptable level on this premise.

Objective To judge the effect of plasma exchange (PE) to the patients with severe hepatopath of nonage according to evaluating the change of the liver function of reserve with 13C-methacetin breath test. Methods There are two groups: the case group and the control group. Each group has 30 patients. The patients in the case group were treated by PE. All the patients received 13C-methacetin breath test at before or one week after treatment. MVmax40, CUM40 and CUM120 were present. At the same time, clinical symptoms, glutamate-pyruvate transaminase (ALT), total bilirubin (TBiL) and prethrombin active (PTA) were observed. Results MVmax40, CUM40, CUM120 and PTA were higher, ALT and TBiL were lower in the case group after treatment (t=4.679, 4.752, 5.048, 5.413, 6.208, 7.413, P=0.000,P<0.01). After a week, MVmax40, CUM40, CUM120 and PTA were higher, ALT and TBiL were lower in the case group than that in the control group (t=2.260, 2.247, 2.476, 4.017, 3.250, 3.658, P<0.05). The total effective rates in the case group and the control group were 83.3 % (25/30) and 43.3 % (13/30),which are significant different(χ2 10.335,P<0.01). Conclusion PE can im-prove the liver reservation functionin the severe hepatopath of nonage.

Objective To explore a surgical method for the treatment of lumbosacral spinal tuberculosis by combination of one-stage focus debridement with anterolateral incision, bone graft fusion with titanium mesh cage and internal fixation with double pedicle crew system.Methods From Sep.2009 to Dec.2012, a total of 8 patients with lumbosacral spinal tuberculosis which included 5 cases of male, 3 cases of female.The age ranged from 20 to 65 years, with a mean of 51.6 years.All patients presented with persistent back pain, 4 patients with radiating pain of unilateral lower limb, 3 with weakness and numbness and 5 with constitutional symptoms including low-grade fever and weight loss.All patients were not associated with active tuberculosis in oth er parts of the body.The patients were given regular anti-TB treatment for at least 4 weeks.By anterolateral incision, common iliac and iliac arteries and veins were dissociated extraperitoneally.The focus was completely debrided through the inferior part of vessels.Then the bone graft fusion was performed with the titanium mesh cage and the internal fixation with a double pedicle crew system was accomplished.After the surgery, patients were treated with continuous anti-TB drugs and with antibiotics to prevent infection.Patients were allowed to move with the protection of waist early and regular follow-up.Results Operation time was 180-360 min, with an average of 225 min.Operative blood loss was 624 ml and drainage volume was 150 ml on average.All cases were cured after surgery.No severe complications were observed during the surgeries.After follow-up of 8 to 30 months (averaged 12months), no recurrence of the tuberculosis was found.The lumbocrural pain improved in all the patients.Complications such as migration, loosening and breaking of the implants were not observed.The vertebral bodies were fused in all patients with an average time of 8.3 months.No case occurred angiemphraxis or internal bleeding.Conclusion The method debrids the focus of lumbosacral spinal tuberculosis thoroughly and implements titanium mesh cage and double pedicle crew system simultaneously.The pedicle screw system is implemented in anterior lumbosacral vertebrae through the inferior part of iliac arteries and veins, which will not lead to angiemphraxis or vascular injuries.The early term outcome is encouraging.This technique is safe and effective to treat severe lumbosacral spinal tuberculosis.

Objective To observe the impairment of different doses of cyclosporine A (CsA) to the rat myocardial tissue to offer scientific evidence for the long-term safe application of CsA in heart transplantation. Methods Eighty-four female Wistar rats, each weighing of (200 ± 25)g, were randomly divided into 12 groups. On days 7,14,21 after a constant peritoneal injection of CsA(0,5,10,15 mg/kg) and 1 ml physiological saline in control group, the rats were put to death, the rat myocardial tissue taken, to observe the pathologic and structural changes of the tissue cells under light microscope and electron microscope. The contents of rat myocardium tissue malondialdehyde(MDA) and superoxide dismutase(SOD) were measured;cardiomyocyte apoptosis was detected and accounted, apoptosis index(AI) was measured with the method of TUNEL. Results Small dose of CsA(5 mg/kg)had no obvious effects on cardiac tissue, in CsA groups of 10 mg/kg and 15 mg/kg, under the light microscope, there appeared edema, degeneration and necrosis of myocardium, part of cardiac myocyte had different level cavity;under the electron microscope, there appeared mitochondria damage, nucleus shrinkage and chromatic margination, part of cardiac myocyte had focus cavity. There was dilated endoplasic reticulum in the sarcoplasm. The effects of different time and dose on MDA content of rat myocardium tissue had statistical significance (F = 6.37,10.15, both P < 0.05). Interaction between time and dose existed statistical significance (F=7.14, P< 0.05). The MDA contents of CsA group of 10 mg/kg and 15 mg/kg were [(2.29 ± 0.18), (3.10 ± 0.45), (2.57± 0.37)nmol/L] and [(3.09±0.63), (3.32 ±0.52), (3.34 ± 0.29)nmol/L] on days 7,14,21 after a constant peritoneal injection of CsA, which were obviously higher than the control group [(1.98 ± 0.20), (2.04 ± 0.52), (1.99 ± 0.26) nmol/L, all P < 0.05], respectively. The effects of different time and dose on SOD activity of rat myocardium tissue had statistical significance(F = 8.43,11.69, both P < 0.05). Interaction between time and dose existed statistical significance(F = 9.86, P < 0.05). The SOD activity of CsA groups of 10 mg/kg and 15 mg/kg were (15.95 ± 1.00), (12.74 ± 1.31), (14.01 ± 0.81)nmol/L and (13.04 ± 1.01), (14.68 ± 0.81), (14.01 ± 0.63)nmol/L on days 7,14,21 after a constant peritoneal injection of CsA, which were obviously higher than the control group [(10.38 ± 0.80), (9.73 ± 0.58), (10.20 ± 0.26)nmol/L, all P < 0.05], respectively. Apoptosis nucleus appeared huffy or brown under the light microscope. The effects of different time and dose on AI of rat myocardium tissue had statistical significance (F = 10.02,20.46, both P < 0.05). Interaction between time and dose existed statistical significance (F = 15.73,P < 0.05). The AI of CsA groups of 10 mg/kg and 15 mg/kg were (6.91 ± 0.70)%, (11.10 ± 2.05)%,(19.81 ± 5.00)% and (11.02 ±2.02)%,(15.51 ± 1.31)%,(33.40±6.60)% on days 7,14,21 after a constant peritoneal injection of CsA, which were obviously higher than the control group [(4.40 ± 0.13)%, (4.60± 1.20)%, (5.20 ± 1.10), all P < 0.05] and CsA group of 5 mg/kg [(4.60 ± 0.10)%, (5.00±2.11)%, (5.43± 1.11)%, all P < 0.05], respectively. Conclusion Small dose of CsA has no obvious effects on cardiac tissue, but large dosage can induce myocyte apoptosis and damage by causing oxidative stress;after implantation, attention should be paid to cardiac impairment due to constant large dosage of CsA.

Objective To explore the tobacco control project based health education curriculum reform's effect of improving medical students' tobacco control.Method Choosing the students of two classes of students in preventive medicine specialty of Harbin Medical University as the research object, investigating the students respectively with the questionnaire prepared uniformly by 7 schools before and after the course.All data were coded by Epidata 3.0, and SPSS 18.0 was used to carry out the relevant information for the chi square test and t test.Result The sample size of baseline survey was114 and after the intervention was 87.The knowledge pass rate of the girls before and after the intervention were 87.3％ (48/55) and 98.2％ (54/55) respectively (P=0.000).The boys' awareness rate of the secondhand smoke safety level were 13.6％ (8/59) and 21.9％ (7/32) respectively, and the girls were 13.0％ (7/55) and 31.5％ (17/55) (P=0.021).Students interested in tobacco increased from 79.8％ (91/114) before intervention to 90.8％ (79/87) after intervention (P=0.033).Students willing to work in the tobacco related increased from 52.2％(59/114) before intervention to 66.7％ (58/87)after intervention (P=0.044).The girl who replied after intervention I am not smoking now, but won't smoke either when working in the disease control in the future reached as high as 96.4％ (53/55), but the students were lack of confidence to help people to stop smoking.Conclusion The reform of social practice activity curriculum designed for tobacco control project is effective, and it is urgent to strengthen the training of preventive medical students' smoking cessation skills and enhance their confidence.

Objective To explore strategies and measures to improve hand hygiene (HH)compliance and correctness of health care workers (HCWs)in a large hospital.Methods The WHO multimodal hand hygiene improvement strategy was adopted by healthcare-associated infection(HAI)management department of a hospital,measures consisted of five key com-ponents,including:system change,education and training,evaluation and feedback,reminders in the workplace,and insti-tutional safety climate.HH compliance and correctness of HCWs were observed by infection control practitioners,HH compliance and correctness in January-June of 2012 (pre-intervention)and January-June of 2014 (post-intervention)were compared,effectiveness of intervention strategies were evaluated.Results HH compliance rate and correctness rate of post-intervention were both higher than pre-intervention (75.92% [8 369/11 023]vs 53.67% [5 127/9 553],P <0.001;94.11%[7 782/8 269]vs 83.88%[3 642/4 342],P <0.001).Of different occupations,HH compliance rates of doctors and nurses were significantly different before and after intervention (both P <0.001),while workers and staff of other oc-cupations before and after intervention were not significantly different(both P >0.05).Except ‘after body fluid exposure’, HH compliance rates of the other four indications for HH before and after intervention were significantly different(all P <0.001).Conclusion HH compliance and correctness of HCWs can be improved after adopting WHO multimodal hand hy-giene improvement strategy.

Objective To investigate the clinical effect of cisplatin and nedaplatin through comparing the effects of synchronous radiotherapy and chemotherapy of cisplatin and nedaplatin on patients with locally advanced cervical cancers.Methods Clinical data of 54 cases of patients with locally advanced cervical cancers received treatment at our hospital from 2009 to 2011 were analyzed retrospectively.Patients were divided into two groups according to the treatment:group DDP (cisplatin) and group NDP (nedaplatin).The general information,short-term effect,long-term curative effect,and adverse reactions were compared between two groups.Results The general information including gender,age,body mass index (BMI),stages,and pathology had no statistically significant difference between two groups.The response rate (RR)of patients in each group was 100％.The complete remission (CR) rate between groups NDP and DDP had no statistically significant difference.Among the patients ≤60 years old,the CR rate,the survival rate of 1,2,and 3 years,and the median progression-free survival (PFS) had no statistically significant difference.Among the patients ＞ 60 years old,the survival rate of 1,2,and 3 years,and the median PFS had no statistically significant difference,but the CR rate had statistically significant difference.In the non-hematological toxicity,the incidence rate of nausea and vomiting,the effect on renal function in group NDP were obviously lower than those in group DDP.There was no significant difference in liver function damage.In the hematological toxicity,there was no statistically significant difference in the incidence rate of anemia and leukopenia.The incidence rate of decrease of platelet in group NDP was higher than that in group DDP,but it was mainly reflected in the Ⅰ and the Ⅱ level.Conclusions Cisplatin had the same efficacy of concurrent chemoradiotherapy with nedaplatin for the treatment of locally advanced cervical carcinoma with a worse tolerance.