Objective To investigate the internal fixation for distal humeral fractures and its outcome .Methods A total of 74 patients with distal humeral fractures were performed surgical operation between Jan 2006 and Jun 2009 .According to AO/ASIF classification ,the factures were classified as type A (n=26) ,B(n=34)and C(n=14) .Internal fixation was applied to the patients , who did functional exercises after operation ,on the basis of classification .The healing of the fractures and the function the joints was examined via follow-up and X-ray films 1 ,3 and 6 months after operation .Results According to the Jupiter elbow score ,40 ca-ses were excellent ,22 cases were good ,12 cases were fair and 0 case was poor ,and the good rate was 83% .Conclusion Internal fix-ation with double plate ,is an effective therapeutic approach to distal humeral fractures in adults .Influencing factors of the efficacy include severity of the initial trauma ,operative scheme ,and post-operation functional recover .

ObjectiveThe aim of this study is to investigate whether oral administration of collagen Ⅱ peptide (250-270)[C Ⅱ (250-270)]-cholera toxin B subunit (CTB)complex could effectively set up oral immune tolerance to collagen-induced arthritis (CIA) in mice. MethodsDBA/1 mice were divided into Ⅰ, Ⅱ, Ⅲ and Ⅳgroups. Group Ⅰ was normal control group. Collagen type Ⅱ emulsified in Freund's complete adjuvant were injected to mice of groups Ⅱ , Ⅲ and Ⅳ twice from the base of the tail. Mice of group Ⅲ were fed with C Ⅱ (250-270)-CTB covalent complex twice after the arthritis was developed. Mice of group Ⅳ were fed with C Ⅱ(250-270) and CTB mix at the 14th day after primary immunization. Visual scores and histopathologic scores of arthritis were recorded. The frequencies of arthritis between the groups were compared usingFisher's exact test. The clinical and histological severity of arthritis were analyzed by ANOVA.Results The frequencies of arthritis in groups Ⅰ , Ⅱ , Ⅲ and Ⅳ were 0, 100％, 100％ and 25％ respectively. Average accumulative scores of arthritis were 0, 5.0±1.7, 10.8±2.8 and 1.0±2.0 respectively. Average accum-ulative histopathological scores of arthritis were 0, 16±8, 32±13 and 7±6 respectively. Conclusion Oral administration of C Ⅱ (250-270) and CTB mix in arthritis mice after C Ⅱ immunization can suppress the onset and severity of arthritis. Oral administration of C Ⅱ (250-270)-CTB covalent complex in the acute stage of arthritis can accelerate arthritis.

Objective:Because of the lower proliferation ability of periodontal ligament cells of elderly people,how to choose suitable scaffold materials for them becomes very important.The aim of this study was to observe the morphological manifestation of the periodontal ligament cells of elderly people seeded onto the three-dimensional porous nano-hydroxylapatite scaffolds.Methods: Periodontal ligament cells from elderly people were seeded onto the three-dimensional porous nano-hydroxylapatite scaffolds,cultured for 15 days in vitro,and observed for the morphological changes by scanning electron microscopy in comparison with those of young people.Results:Fifteen days after seeded on the three-dimensional porous nano-hydroxylapatite scaffolds,the periodontal ligament cells of the elderly people exhibited sufficient adhesive behavior,proliferated well and produced tiny calcium nodules,but the number of the nodules was smaller than that in the young people.Conclusion: The periodontal ligament cells of elderly people grow well on three-dimensional porous nano-hydroxylapatite scaffolds,and can be considered as a suitable scaffold for periodontal tissue engineering in elderly people.

Objective To explore the role of CD3 +CD8 +T cells in children with severe bacterial meningitis at early stage by studying the changes of CD3 +CD8 +T cells and its relationships with markers of inflammation and humoral immunity. Methods Thirty-nine cases aged ≤14 years old were enrolled in this retrospective study,who were admitted in our PICU from Aug 1. 2014 to Dec 31. 2015 with diagnosis of se-vere bacterial meningitis. The patients were divided into 2 groups according to the changes of CD3 +CD8 + T cells:group A:normal or elevated(≥190/mm3,n=22),group B:decreased( <190/mm3,n=17). Distribu-tion and differences of biomarkers of inflammation,humoral immunity and changes in cerebrospinal fluid be-tween the two groups were analyzed. Results The ratio of CD3 + CD8 + T cells were decreased in 17 (43. 6%)cases. Though there was no statisticly significant difference,the percentile of patients in group B (58. 8%) with Glasgow coma score lower than 8 was higher than that in group A(31. 8%). All the four death were in group B. The mean values of C-reactive protein and procalcitonin were 251. 0(26. 2,417. 0) mg/L,32. 7(0. 9,100. 0) ng/L in group B,which were higher than those in group A[106. 5(12. 0,458. 0) mg/L,4. 5(0. 1,200. 0)ng/L],respectively(P<0. 05). Six cases(35. 3%) in group B with WBC<4 × 109/L was more than 1 case(4. 6%) in group A,and 12 cases(70. 6%) in group B with ratio of neutrophils>80% was more than 7 cases(31. 8%) in group A,there were significant differences(P<0. 05). Fourteen cases(82. 3%) with glucose concentration lower than 2. 0 mmol/L in group B was more than 11 cases (50. 0%) in group A,the difference was significant(P<0. 05). Conclusion CD3 +CD8 +T cells might be suppressed in children with severe bacterial meningitis at early stage,and might associate to the damaging de-gree of brain,inflammation reaction and prognosis in those patients,which should be helpful in using of im-mune regulators for children with severe bacterial meningitis.

Objective To observe the effect of liver disease special-purpose enteral nutrition preparation on protein metabolism and liver function in children with liver injury.Methods Sixty cases of severe ill with liver injury in hospital,with mean age of (7.8?6.3) years old.All patients were randomly divided into experimental group (n=30) and control group(n=30).The experimental group was treated by adding the liver disease special-purpose enteral nutrition preparation homogenized diet and control group was treated by adding entire protein entire nutrition type enteral nutrition preparation.All patients in both 2 groups were nasally fed with intestinal nutrition,which contained 418-628 kJ/(kg?d).One day before nutritional support and 14 days after nutritional support,the liver function,total serum protein,albumin,hemoglobin were recorded.SPSS 11.5 software was used to analyze the data.Results The baseline indicators were similar before nutritional supports.Fourteen days after nutritional support,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were all significantly lower in experimental group than in control group(Pa

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.

Objectives To explore the route of ESBL producing bacteria in neonatal faeces, and to investigate the gene and drug resistance of ESBL producing bacteria in intestinal tract of neonates. Methods Fecal samples of healthy newborns and their mothers were collected, and bacterial cultures were carried out using selective ESBL medium. The positive strains were identified by Time-of-flight mass spectrometry. ESBL genotyping and resistance gene detection were performed by whole genome sequencing technique. Results In 146 neonatal fecal specimens, the positive rate of ESBL producing bacteria was 8.90％,and the positive rate in the first time stool was 3.23％. Seventy-two hours after birth, the positive rate of fecal ESBL producing bacteria was 13.10％. Among the 13 ESBL producing strains, there were 9 strains of CTX type, 3 strains of TEM type and 1 strain of SHV type. Nine strains of CTX include five types such as CTX-M-24, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. The positive rate of ESBL producing bacteria was 21.6％ in 167 mothers' fecal specimens. The ESBL genotype included 24 strains of CTX type, 6 strains of TEM type, 4 strains of SHV type and 2 strains of QnrS type. Twenty-four strains of CTX include CTX-M-24, CTX-M-14, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. There were 2 or 3 ESBL genotypes in 12 maternal and neonatal specimens. It was detected to have 6 types of resistance gene such as aadA5, strA, strB, sul1, sul2 and dfrA17 in 49 strains of ESBL producing bacteria in maternal and neonatal strains. Resistance genes were exactly the same in the neonates as in mothers who were detected to have ESBL producing bacteria. A variety of resistance genes were detected in feces in 7 neonates and 23 mothers. Conclusions The neonates in hospital may be detected to have ESBL produing bacteria in the intestinal tract at the same time as their mothers or separately. However, there are many ways for neonates to have ESBL producing bacteria in intestinal tract. There are many genotypes and resistance genes of ESBL producing bacteria.

Objective Combined with susceptibility weighted imaging (SWI) and proton magnetic resonance spectroscopy (1H-MRS) to study the hippocampus in the first-episode depression patients for exploring the causal relationship.Methods 20 first-episode depression patients and 20 healthy volunteers underwent SWI scanning and hippocampal 1H-MRS image,analysis and comparison the changes between the venous system and metabolism of two groups.Results Proton spectroscopy analysis showed that compared with the control group,bilateral hippocampal NAA/Cr(left hippocampus:depression group 0.95±0.77,control group 1.78±0.82; right hippocampus:depression group 1.12±0.74,control group 1.91 ± 0.80) and Cho/Cr (left hippocampus:depression group 1.08±0.83,control group 1.75±0.73 ; right hippocampus:depression group 0.91±0.68,control group 1.95 ±0.74) in the depression group was significantly lower,the difference was significant(NAA/Cr:t value in left and right were -3.14,-3.49,P＜0.05; Cho/Cr:t value in left and right were-3.25,-3.19,P＜0.05),however MI/Cr had no obvious changes (t value in left and right were 1.24,-1.27,P＞0.05).Magnetic sensitive scan showed depression group compared with the control group was significantly reduced in lateral vein diameter,length and branches (t value were 3.23,4.56,2.66,P＜0.05).Conclusion The SWI sequence and 1H-MRS imaging methods can become a new research idea about the central nucleus,and this idea may explain the causal relationship between the hippocampus in depression patients of vascular abnormalities and hippocampal neuronal metabolic abnormalities.

″Herb-Pairs″, also known as pair drugs, refers to a prescription consisted of two relatively fixed traditional Chinese medicine, is the most basic, most simple and most common form of medication prescription in traditional Chinese medicine compound compatibility. It is not a random combination of two herbs, nor is the simple accumulation of efficacy, but the simple and delicate experience of ancient Chinese medicine practitioners. As a bridge between single drug and prescriptions, it is the embodiment of the regular and dialectical connotation. Therefore, research on Herb-Pairs has always been the most basic and most important entry point for compound compatibility studies. However, the interaction between herbs and herbs is an effect with a downside as well as benefits. The beneficial herb-herb interaction in Herb-Pairs include mutual promotion, mutual enhancement, mutual restraint between two drugs and counteract toxicity of another drug. And the harmful herb- herb interaction in Herb- Pairs includes mutual inhibition and antagonism. All of these interactions areby means of affecting the metabolism of components to play a therapeutic effect. Using the pharmacokinetic-pharmacodynamic (PK-PD) binding model, the combination of drug metabolism and pharmacodynamics can further elucidate the influence on effect caused by drug concentration and metabolism, which can help elucidate the mechanism of drug action. Consequently, in this review, the herb-herb interactions in terms of pharmacokinetic were summarized to elucidate rule of TCM compatibility.

Intensifying the continuing education of doctors in hospitals at primary level is one of the important measures for increasing their specialized skills and improving the condition of primary care.In recent years,following the trend of national medical reform,the Fourth Military Medical University (FMMU) has made full use of its advantages to provide training for civilian doctors in hospitals at primary level.In the training,with the reform measures of ‘ four focuses' and ‘ five combinations',FMMU actively advanced teaching reform to make innovations in curriculum system and teaching methods,which was approved by teachers and students.These measures were very effective,which in turn greatly enhanced the ability of the doctors and training quality.This practice obviously pushed forward development of primary-level medical and health-care service in Shanxi province.