0.1), the results suggested that the stiffness of resistant torque of ITBW was similar to that of CW. In the bending test, in order to give rise to the fragmental displacement of 2.30? induced by bending load, the bending force of 3.3Nm was needed in ITBW fixation, and was 1.9 Nm greater than CW fixation, so stiffness resistant to bending of ITBW was 2.3 times of that of CW. The patients were followed up from 6 to 78 months, with an average of 38 months. There were no complications of nerve and vessels injury, infection and wire or nails loosening. Varus elbow happened in 2 cases, the mean varus angel was less than 5?. 2 cases and All the cases treated with ITBW healed uneventfully with good functions, there were excellent 32 cases and good 12 cases according to the Flynn evaluation system. Conclusion The fixation effect of ITBW is much better than that of CW. The stability provided by ITBW makes external fixation unnecessary and allows for early mobilization of the elbow. The ITBW technique is in satisfactory agreement with biomechanical principle. It is valuable for widely clinical application.

Objective To investigate the treatment effects of different fixation for fracture and dislocation of ankle joint and to sum up the experience for clinical treatment.Methods One hundred and fifty patients with fracture and dislocation of ankle joint using 5 different internal fixation surgeries were involved with this research:simple cross Kirschner wire fixation,intramedullary fixation ordinary screws,cancellous lag screw fixation,4 holes common plate fixation,tension band fixation.Patients were followed up and evaluated by the American Orthopedic Foot and Ankle Society Score for scoring,and investigated the postoperative recovery and the occurrence of postoperative infections and complications in patients.Results After followed up from 12 to 24 months with an average follow-up time of 19 months,of 150 patients,there were 29 cases with excellent result,65 cases with good result,44 cases with general and 12 cases with poor result,the excellent and good rate was 62.6％ (94/150).One case with nonunion,6 cases with malunion,7 cases with traumatic arthritis,10 cases with wound pain,the incidence of postoperative complications was 16.0％ (24/150).There were 10 cases with shallow infection,5 cases with deep infection,and 11 cases with severe skin irritation; The incidence of postoperative infection was 17.3％ (26/150).Conclusion Surgical treatment is the main treatment of fracture and dislocation of ankle joint,5 different methods of internal fixation of ankle fractures had good therapeutic effect.

ObjectiveTo compare and observe the clinical effect of Qizhengxiaotong plaster and Votalin emulsion in curing osteoarthritis of knee (KOA) for outpatient treatment.MethodsIn 70 cases,the KOA patients are randomly divided into treatment group and control group,respectively given Qizhengxiaotong plaster plus Xianling Gubao and Votalin emulsion for one month.To observe the clinical effects of patients respectively pre and post treatment.ResultsAfter a course of treatment,Qizhengxiaotong plaster plus Xianling Gubao could improve the clinical symptoms and signs significantly.Its improvement for pain was the same as Votalin.But Qizhengxiaotong plaster plus Xianling Gubao was significantly better than Votalin in eliminating the swollen,tenderness and dysfunction.And there was no obvious difference between Qizhengxiaotong plaster plus Xianling Gubao and Votalin emulsion in total effective rate,evaluated by WOMAC Osteoarthritis Index Guide and VRS-5.The typical symptoms were improved after the therapeutic method.No adverse reaction was found during the treatment.ConclusionQizhengxiaotong plaster plus Xianling Gubao had obvious effect on the osteoarthritis of knee and could improve the patients' pain and limitation of activity.Hence,it was worthy to be generalized in the conservative treatment of the osteoarthritis of knee for out-patients.

0.05).But there was a significant statistical difference among those parameters between Group A and Group B at final follow up(P

Objective To explore the feasibility of single port laparoscopy in classification and treatment of Meckel's diverticulum in children and its guiding treatment.Methods The clinical data in 75 children cases of Meckel's diverticulum with symptoms treated in our hospital from Aug.2011 to Aug.2015 were retrospectively analyzed.Meckel's diverticulum was classified under single port laparoscopy.The operation modes were selected according to different classifications.The excised materials were submitted to the pathologic examination.Results Among 75 children cases,50 cases were the simple type of Meckel's diverticulum and 25 cases were complex type of Meckel's diverticulum.The average operative time in the simple type and complex type was (38.93±8.75) min and(55.64 ± 13.27) min respectively,average bleeding amounts were (46.58 ± 15.81) mL and (50.12 [16.90) mL respectively,average postoperative hospitalization time was (7.33±1.41)d and (7.52 ± 1.68)d respectively,the operative time in the simple type was less than that in the complex type(P＜0.05),the other two indexes had no statistical difference between the two groups(P＞0.05).The ectopic gastric mucosal pathological change was only seen in the simple type,while the inflammatory manifestation in the complex type had higher proportion.The main clinical manifestations were lower gestational tract bleeding and infection.The two groups all obtained follow up.One case of simple type appeared the symptoms of abdominal pain and hematochezia and was cured after the second operation.Conclusion Meckel's diverticulum can be divided into the simple type and complex type under single port laparoscopy.The operation mode can be selected according to different types.This method is safe and reliable and is worthy of being clinically promoted.

Contrast induced nephropathy (CIN)is one of the main complications caused by intravenous iodinated contrast media injection,which can increase hospitalization rate and mortality of patients,and it has become the third main cause of acquired acute renal failure in hospital currently, but its fundamental pathogenesis is still not clear,which is considered to be related to inflammation and oxidative stress response etc.The present article made a review on pathogenesis of CIN and preventive effects of statins on CIN.

Objective The goal of this study is to understand the function of FKBP51 in resistant to high fat diet-induced obesity using FKBP51 knockout ( KO) mice and in vitro adipocyte differentiation.Methods Four-week old male FKBP51 KO and wild type ( WT) mice were fed separately with regular or high fat diet for 6 weeks.The body weight and food consumption were recorded weekly, the energy expenditure differences ( O2 consumption, CO2 production, respiratory exchange ratio, and heat production) of each group were monitored using the MM-100 metabolism cages system for 24 hours, then the liver from the above animals were stained with the Oil red-O to detect the lipid accumulation and the expression of metabolic genes.In addition, induction of adipocyte differentiation of immortalized MEF cells from WT and FKBP51 KO mice were used to observe the effect of FKBP51 gene on lipogenesis.Results Compared to WT mice, FKBP51 KO mice has less weight increment, and less lipid accumulation in the liver, but with no difference on food consumption during high-fat diet fed.Moreover, FKBP51 KO mice exhibited more O2 consumption, CO2 production and heated production under both RD and HF diet conditions.The PEPCK, G6Pase and UCP-1 genes up-regulation.In addition, lipid content was reduced in FKBP51 gene deficient MEF cells after adipocyte differentiation.Conclusions The FKBP51 gene plays an important role in high fat diet-induced obesity through the energy metabolism enhancement and lipogenesis inhibition.

Objective To evaluate the effects of the serum in the patients with obstructive jaundice on the proliferation,migration and phenotype modulation of human pulmonary arterial smooth muscle cells (PASMCs).Methods PASMCs were isolated from the patients,underwent passage and were then subcultured.The cultured PASMCs were incubated with the serum in the patients with obstructive jaundice or with the serum in the healthy volunteers.At 24,48 and 72 h of incubation,the proliferation and migration of the cells were determined by CCK-8 assay and wound healing assay,respectively,and Western blot analysis was used for detection of smooth muscleα-actin (SM-α-actin) and calponin protein expression in human PASMCs.Results The proliferation and migration of human PASMCs were significantly enhanced,calponin protein expression was up-regulated at 24 h of incubation,and the SM-α-actin and calponin protein expression was down-regulated at 48 and 72 h of incubation when human PASMCs were incubated with the serum in the patients with obstructive jaundice as compared with those when the cells were incubated with the serum in the healthy volunteers.When human PASMCs were incubated with the serum in the patients with obstructive jaundice,the proliferation and migration of the cells were significantly enhanced,SM-α-actin expression was up-regulated and calponin protein expression was down-regulated at 48 h of incubation as compared with those at 24 h of incubation.When human PASMCs were incubated with the serum in the patients with obstructive jaundice,the migration of the cells was significantly enhanced,and no significant change was found in the proliferation and SM-α-actin and calponin protein expression at 72 h of incubation as compared with those at 48 h of incubation.Conclusion The serum in the patients with obstructive jaundice can enhance the proliferation and migration of human PASMCs and promotes synthetic PASMC phenotype.

Objective To determine the median effective dose (ED50 ) of ropivacaine for spinal anesthesia when combined with sufentanil in patients undergoing caesarean section. Methods Twenty-eight ASA Ⅰ or Ⅱ parturients, aged 18-40 yr, weighing 50-110 kg, undergoing cesarean section under combined spinal-epidural anesthesia, were enrolled in this study. Combined spinal-epidural anesthesia was performed at L2,3 interspace. The mixture of ropivacaine and 5 fig sufentanil was injected into the subarachnoid space over 30 s. The initial dose of ropivacaine was 11 mg. The dose was increased/decreased by 1 mg in the next patient. The ED50 and 95% confidence interval were calculated by up-and-down method. Results The ED50 of ropivacaine was 7.780 mg (95% confidence interval 6.850-8.836 mg). Conclusion When combined with sufentanil 5 μg, the ED50 of ropivacaine for spinal anesthesia is 7.780 mg in patients undergoing caesarean section.

Objective To investigate the role of serine threonine protein kinase-1 (Akt1) and Smad3 in lung tissues in development of hepatopulmonary syndrome in rats.Methods Seventy-two healthy male SpragueDawley rats,aged 3-4 months,weighing 200-250 g,were randomly divided into 3 groups (n=24 each):control group (C group),sham operation group (S group) and common bile duct ligation (CBDL) group.The rats were anesthetized with 3％ pentobarbital sodium 45 mg/kg.In group CBDL,laparotomy was performed,the common bile duct was ligated and then the abdomen was closed,while the common bile duct was only exposed,but not ligated and then the abdomen was closed in group S.At 1st,3rd and 5th weeks (T1-3),8 rats were chosen randomly in each group and blood samples were obtained from the abdominal aorta for blood gas analysis.The rats were then sacrificed and lungs were isolated to detect the expression of Aktl and Smad3 mRNA and protein in lung tissues (by RT-PCR and Western blot).The lung tissues were sliced and stained with hematoxylin eosin for examination of the pathological changes of pulmonary capillaries.Results Compared with C and S groups,the expression of Akt1 and Smad3 mRNA and protein in lung tissues was significantly up-regulated at T2,3,and alveolar-arterial oxygen tension difference was increased at T3 in CBDL group (P ＜ 0.05).The pulmonary capillary was obviously dilated at T3 in CBDL group.Conclusion The expression of Akt1 and Smad3 in lung tissues is up-regulated,which may be one of the mechanisms of development of hepatopulmonary syndrome in rats.