Objective To investigate the clinical results of Link anatom ical distal femoral plate in treatment of distal femoral fractures. Methods 39 c ases of distal femoral fractures who were admitted after February 2001were treat ed with Link anatomical distal femoral plate. All the 39 cases were followed up for 7 to 26 months. Results All the fractures got united, without complications of no-union, screw loosening or plate breakage. The excellent rate of the knee function was 89.74%. Conclusion Link anatomical distal femoral plate, when used to treat distal femoral fractures, is simple to handle, gives reliable fixation , and facilitates rehabilitation of the knee.

Objective To investigate the clinical characteristics, management and prognosis of gestational trophoblastic disease in women aged 50 years or more. Methods Thirty-eight cases of gestational trophoblastic disease in women aged 50 years or more, who were treated in Peking Union Medical College Hospital between 1992 and 2002, were reviewed retrospectively. Results The median age was 52 years (range from 50 to 58 years ). The lesions included 5 hydatidiform moles (13%), 19 invasive moles (50%), 12 choriocarcinomas (32%) and 2 placenta site trophoblastic tumors (5%). All of 38 cases presented with abnormal vaginal bleeding. Twenty-three cases of hydatidiform moles were diagnosed at their first visit to the hospital, and 15 of them received prophylactic chemotherapy, of whom 10 progressed to invasive mole, 3 developed lung metastasis. All of the other 8 cases without prophylactic chemotherapy progressed to malignant changes with metastasis of lung. The use of prophylactic chemotherapy reduced the incidence of subsequent metastasis. All of 38 cases received chemotherapy. Thirty-two cases underwent hysterectomy, complete remission was achieved in 91% of patients; complete remission was achieved in 2 of 6 patients without hysterectomy. Conclusions The diagnosis of pregnancy and pregnancy-related disease should be considered in the elderly women presenting with abnormal vaginal bleeding. Once gestational trophoblastic disease in women aged 50 years or more is diagnosed, chemotherapy should be given as soon as possible. Hysterectomy is frequently required to improve the prognosis of gestational trophoblastic disease in the elderly women.

Objective To establish an HPLC fingerprint ofJinjing solid beverage,and provide experimental evidence of evaluating its quality.Methods Ten batches ofJinjing solid beverage were analyzed by HPLC under the gradient elution condition. A Kromasil C18 column(4.6 mm×250 mm, 5μm) was used, and the flow phase was acetonitrile-H2O(acidified to 0.1% with phosphoric acid) with gradient elution, and the detection wavelength was 327 nm, and the flow rate was 1.0 ml/min, and the column temperature was 35℃. The data were evaluated by the similarity evaluation software for TCM fingerprint.Results The HPLC fingerprint ofJinjing solid beverage were established. Twelve common peaks including chlorogenic acid were identified with similarity of more than 0.9.Conclusion HPLC method is a reliable, available and quick method, that provides a means for controlling and evaluating the quality ofJinjing solid beverage.

Purpose To summarize the imaging features of inflammatory bowel diseases (IBD) with double-filling method using multi-slice CT enterography (MSCTE), and to evaluate the clinical significance of MSCTE in diagnosis of IBD. Materials and Methods MSCTE data with double-filling method of 52 patients with IBD were retrospectively analyzed. 52 IBD patients included 42 cases of Crohn's disease (CD) and 10 cases of ulcerative colitis (UC). Bowel dilatation and lesions display were evaluated. Results Among 52 patients, ileum dilated optimal in 10 cases (19.23%) and good in 42 cases (80.77%); jejunum dilated good in 21 cases (40.38%) and poor in 31cases (59.62%). Exhaustive evaluation for large bowel diseases were good in 50 cases (96.15%). The ileocecal junction displayed well in 52 cases (100.00%). Among the 42 cases of CD, 20 cases (47.62%) had lesions limited in the small intestine, 22 cases (52.38%) had lesions involved both small intestine and colon. Among 10 cases of UC, 9 cases had lesions limited in the colon, and 1 case with the terminal ileum and the colon involved simultaneously. The MSCTE findings of 52 patients included bowel wall thickening and abnormal enhancement in 52 cases, stenosis in 28 cases, increased mesenteric vascularity in 46 cases, enlarged mesenteric lymph nodes in 27 cases, phlegmon in 10 cases, incomplete intestinal obstruction in 4 cases, abscess or inflammatory masses in 7 cases, fistulas in 3 cases, perianal lesion in 12 cases, serous cavity effusion in 15 cases, sacroiliitis in 13 cases, the urinary and biliary stones in 18 cases, and hepatosplenomegaly in 9 cases. Conclusion MSCTE with double-filling method can delineate the wall lesions of small bowels and colons very well, and can also display extraintestinal lesions and complications. It obviously improves the accuracy of localization and qualitative diagnosis on IBD.

Objective To evaluate the precision and uncertainty and comparison analysis of 6 items blood lipids index among 5 different Beckman AU biochemical testing systems ,such as triglyceride(TG) ,total cholesterol(TCHO) ,high density lipoprotein cholesterol(HDL‐C) ,low density lipoprotein cholesterol(LDL‐C) ,apolipoproteins A1(APOA1) ,apolipoproteins B(APOB) .Meth‐ods According to the document the EP15‐A2 of national Committee for Clinical Laboratory Standards ,6 items blood lipids index were respectively detected by 5 different Beckman AU biochemical testing systems to obtain precision and comparison .The intra‐and inter‐precision and results of comparability among different system were low than 1/4 or 1/3 or 1/2 CLIA′88 as evaluation standard ,respectively .The measurement uncertainty of these items were evaluated by the calibrator uncertainty and internal quality control and external quality control .Results The intra‐and inter‐or day‐to‐day precision and relative bias were accepted by clinical requirements .The expanded measurement uncertainty for TG was 0 .079 mmol/L and 0 .035mmol/L .The expanded measurement uncertainty for TCHO was 0 .248 mmol/L and 0 .157 mmol/L .The expanded measurement uncertainty for HDL‐C was 0 .144 mmol/L and 0 .018 mmol/L .The expanded measurement uncertainty for LDL‐C was 0 .140 mmol/L and 0 .186 mmol/L .The ex‐panded measurement uncertainty for APOA1 was 0 .148 mmol/L and 0 .090 mmol/L .The expanded measurement uncertainty for APOB was 0 .104 mmol/L and 0 .058 mmol/L .Conclusion The results of 6 items blood lipids index respectively show well preci‐sion and significantly correlation among 5 different Beckman AU biochemical testing systems and the results were comparable ,and the influence factor of detection results were expression directly by evaluating the measurement uncertainty of 6 items blood lipids index .This way of assessment is simple .

OBJECTIVETo systematically review the efficacy and safety of sodium ferulate (SF) for the treatment of diabetic nephropathy.

METHODSBy computerized retrieving the Cochrane Library, MEDLINE, EMBASE, CNKI, VIP, CBM (theses, conference and internet materials), as well as data from internet materials regarding randomized controlled clinical trials of sodium ferulate for the treatment of diabetic nephropathy were collected completely. Data were strictly extracted using the simple evaluation method recommended in Cochrane Handbook and Meta-analysis was performed using Revman 5.0 software.

RESULTSFourteen randomized controlled trials involving 906 patients met the inclusion criteria. Meta-analysis showed that as compared with the control group, the effects in SF group were superior in terms of reducing urinary albumin excretion rate (UAER) at early stage [WMD = 16.08, 95% confidence interval (95% CI): 11.01 to 21.15] and clinical stage (WMD = 82.66, 95% CI: 66.95 to 98.37), urinary endothelin/endothelin-1 (ET/ET-1, WMD = 10.78, 95% CI: 8.18 to 13.39), levels of serum creatinine (SCr, WMD = 6.42, 95% CI: 1.83 to 11.01), blood urea nitrogen (BUN, SMD = 1.45, 95% CI: 0.19 to 2.71) and total cholesterol (TC, WMD = 0.84, 95% CI: 0.56 to 1.21, as well as in increasing high density lipoprotein-cholesterol (HDL-C, WMD = 0.17, 95% CI: 0.09 to 0.26), showing significant difference between groups. However, the effects of SF were insignificantly different to those of control in reducing fasting blood glucose (FBG, WMD = 0.17, 95% CI: -0.03 to 0.37) and triglyceride (TG, SMD = -0.13, 95% CI -0.49 to 0.23).

CONCLUSIONSAt present the evidences show that SF is superior to the conventional treatment in reducing UAER, ET, SCr, BUN, TC and increasing HDL-C, but there is no evidence to show that SF is superior in reducing FBG and TG. However, the evidence is not strong enough due to the low quality of included literature. More large-scale, multi-center, randomized trials are needed to confirm the efficacy and safety of SF in treating diabetic nephropathy.

Objective:To investigate effects of miR-503 on cisplatin sensitivity in BEL-7402 cells by targeting of bcl-2.Methods:MiR-503 and bcl-2 mRNA expression levels in hepatocellular carcinoma cells were measured by real-time quantitative (qRT)-PCR;Bcl-protein level was detected by Western blot;miR-503 mimics were transiently transfected to the BEL-7402 cells by liposome transfection;potential target genes of miR-503 were predicted by Bioinformatics software;miR-503 potential targets were validated by dual luciferase activity;and the cell viability was measured by MTT assay.Results:MiR-503 level was down-regulated and Bcl-2 protein expression level was up-regulated in BEL-7402 cells compared with HL-7702 cells.MiR-503 could interact with bcl-2 and inhibit its expression.Cell vitality with miR-503 transfection was significantly reduced compared to that in the negative control.Conclusion:MiR-503 may enhance the sensitivity of BEL-7402 cells to cisplatin and inhibit the cell proliferation by targeting bcl-2.

Objective To evaluate the efficacy of lateral femoral approach to continuous sciatic nerve block for patient-controlled analgesia after foot and ankle surgery.Methods One hundred American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients of both sexes,aged 18-60 yr,weighing 50-100 kg,with body height of 145-190 cm,scheduled for elective foot and ankle surgery,were divided into 2 groups (u =50 each) using a random number table:patient-controlled nerve block analgesia (PCNA) group and patient-controlled intravenous analgesia (PCIA) group.In group PCNA,the lateral femoral approach to sciatic nerve block was performed under the guidance of ultrasound and a neurostimulator,0.2％ ropivacaine 20 ml was injected after successful location,the catheter was inserted,and 0.2％ ropivacaine 10 ml was injected again.In group PCIA,0.2％ ropivacaine 30 ml was injected after successful location of the sciatic nerve.General anesthesia was performed using laryngeal mask airway in both groups.In group PCNA,PCNA was performed with 0.2％ ropivacaine (diluted to 200 ml in normal saline) at the end of surgery,and the PCNA pump was set up with a 0.5 ml bolus dose,a 15-min lockout interval and background infusion at a rate of 5 ml/h.In group PCIA,PCIA was performed with sufentanil 100 μg,tramadol 500 mg and tropisetron 10 mg (diluted to 200 ml in normal saline) at the end of surgery,and the PCIA pump was set up with a 0.5 ml bolus dose,a 15-min lockout interval and background infusion at a rate of 2 ml/h.The visual analog scale score was maintained≤ 3,and postoperative analgesia lasted until postopera-tive 72 h.When visual analog scale scores ≥ 4,tramadol 100 mg was intramuscularly injected as rescue analgesic.The requirement for rescue analgesia and development of adverse effects such as nausea and vomiting,insomnia,puncture site infection and bleeding were recorded within 72 h after surgery.Results The requirement for rescue analgesia and incidence of nausea and vomiting were significantly lower in group PCNA than in group PCIA (P＜ 0.05).Conclusion The lateral femoral approach to continuous sciatic nerve block can be safely and effectively used for patient-controlled analgesia after foot and ankle surgery.

Objective To evaluate the feasibility of modified lateral approach to sciatic nerve block guided by ultrasound and nerve stimulator for foot surgery.Methods Sixty-two patients of both sexes,aged 18-60 yr,with body mass index ＜ 30 kg/m2,of ASA physical status Ⅰ-Ⅲ,scheduled for elective foot surgery,were included in the study.Anesthesia was induced with iv propofol 2-4 mg/kg and sufentanil 0.2-0.4 μg/kg.The laryngeal mask airway was inserted and the patients were mechanically ventilated.Sevoflurane was inhaled continuously.Modified lateral approach to sciatic nerve block was performed with 0.3 ％ ropivacaine 30 ml under the guidance of the ultrasound combined with nerve stimulator.Rocuronium 0.6 mg/kg and propofol 1-2 mg· kg-1 · h-1 were administered after completion of sciatic nerve block.Additional sufentanil 0.10-0.15 μg/kg was intravenously injected immediately after skin incision and rocuronium 0.15 mg/kg was injected intravenously at 1 h intervals.The depth of puncture and time for puncture and success rate of puncture were recorded.Sensory block was assessed after the patients regained consciousness completely.Nerve injury,hematoma at the puncture site and infection within 72 h after surgery were recorded.Results The time for puncture was (40 ± 17) s.The depth of puncture was (5.8 ± 0.7) cm.The success rate of puncture at first attempt was 77 ％.The rate of complete sensory block was 100％.The post-operative follow-up showed that no patients developed nerve injury,hematoma or infection.Conclusion Modified lateral approach to sciatic nerve block guided by ultrasound and nerve stimulator is safe and effective for foot surgery.

Child ; Child, Preschool ; Female ; Hamartoma ; diagnosis ; etiology ; pathology ; Humans ; Immunohistochemistry ; Infant ; Liver Diseases ; diagnosis ; etiology ; pathology ; Male