BACKGROUND:Currently, surgical treatment for Sanders III type, IV type fractures to restore damaged subtalar surface of the calcaneus and calcaneal shape, in order to reduce the incidence of traumatic arthritis has reached a consensus, and whether bone grafting is selected during surgery for calcaneal fractures has been a controversial issue. OBJECTIVE:To observe the clinical effect of Genex synthetic bone transplants and locking plate on comminuted calcaneal fractures. METHODS:Twenty-one cases of Sanders III type, IV type calcaneal fractures were retrospectively analyzed, including 16 males and 5 females, aged 22 to 55 years. After fracture reduction, a dough-like Genex bone graft was implanted into the defect region via lateral“L”shaped approach, and then the lateral wal of the bone was reset fol owed by internal fixation with the pre-curved locking plate. Fol ow-up observation was performed for fracture healing, Bolher angle and the Maryland Foot Score. RESULTS AND CONCLUSION:Total y 21 patients were fol owed up for 8-16 months. The fractures were healed without displacement, col apse and rejection. The bone graft was degraded within 6 months and completed absorbed after 1 year. According to Maryland Foot Score, the excellent rate was up to 86%, and the Bolher angle was increased from an average preoperative (5.3±3.35)° to postoperative (24.3±1.06)°. Genex artificial bone meal is a biomaterial that can be completely absorbed, has good plasticity and strong supporting force, and it is able to ful y fil bone defects, be easy to fracture reduction, induce bone formation, and promote fracture healing.

Objective To compare the ameliorating effect of collagen peptide chelated calcium (CPCC) and estrogen on the bone quality in ovariectomized rats in order to serve the development of safe drugs for prevention of osteoporosis (OP).Methods Bilateral ovariectomized rats were divided into ovariectomized group (OVX),sham group,17β-estradiol injection group (OVX+E2) and CPCC gavage group (OVX+CCCP).Bone and serum indices of these groups were assessed and compared at 9 weeks after treatment.Results Bone density of the OVX group was significantly lower than the sham group (P<0.01),indicating that the rat OP model was successfully established.Like estrogen,CPCC inhibited the abnormal changes of all indices and maintain similar levels with those of the sham group (P>0.05),while the body weight gain of the E2 group at weeks 8 and 9 was significantly lower than those of the sham group (P<0.01).As regarding the prevention of bone loss,the Mg and Ca levels of the E2 group were significantly lower than those of the moderate and high dose CPCC groups.The Cu level was not significantly different compared with the sham group,while those in the moderate and low dose CPCC groups were significantly higher than the sham group.The Mn,Zn and hydroxyproline levels of the E2 group were significantly lower than those of the sham group,while the CPCC group maintained levels similar to that of the sham group.In regarding to the inhibiting effect on the increased blood BGP and StrACP,the E2 group was still maintained at levels similar to that of the OVX group,while those of the CPCC group were significantly lower than the OVX group.As regarding the decreased blood Ca,the E2 group was not significantly different with that of the OVX group,while that of the CPCC group was significantly higher than the OVX group.Conclusions CPCC is more effective than estrogen in ameliorating the bone quality of ovariectomized rats.

Objective To explore the clinical value of color Doppler ultrasoundcardiogram in the screening of congenital heart disease(CHD) in neonates. Methods 29568 neonates were examined by color Doppler ultrasoundcardiogram. Results 369 CHD patients were identified, the overall incidence of CHD was 12.48‰. The incidence in 2009 or 2010 were significantly higher than those in 2005 or 2004 ( all P ＜ 0. 05 ), the mean incidence of four years from 2007 to 2010 was significantly higher than that from 2003 to 2006( 13.78‰ vs 10.17‰,P ＜0. 01 ). Of 369 CHD cases,most of them were ventricular septal defect( occupied 48.24% ) ,next was atrial septal defect( occupied 44.17% ). Conclusion The incidence of CHD ascended rapidly from 2003 to 2010,and color Doppler ultrasoundcardiogram was an important method to diagnose CHD in newborns.

Objective To explore the pharmacodynamic action of the extract from raw materials of Rhizoma Anemarrhenae and Cortex Phellode ndri, a classic herb pair in traditional Chinese medicine, on mice with diabetic peripheral neuropathy(DNP). Methods The mice were administrated with intraperitoneal injection of streptozotocin (STZ, 30 mg/kg) and fed with high-fat diet to establish the DNP mouse model. One hundred and sixty male C57BL/6j mice were divided into normal group, model group, metfomin group(130 mg/kg), Xuezhikang group(200 mg/kg), high- and low-dose Rhizoma Anemarrhenae extract group(360, 90 mg/kg) , high-and low-dose Cortex Phellodendri extract group(135, 45 mg/kg), 20 mice in each group. The medication lasted for 24 weeks. On medication week 8, 16 and 24, the plasma levels of glucose (GLU), total cholesterol (TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C) and insulin(INS) were determined respectively. On medication week 10, oral glucose tolerance test(OGTT)was carried out. On medication week 24, the plasma nuclear factor kappa B(NF-κB) activity and the plasma levels of transforming growth factor-beta 1(TGF-β1), superoxide dismutase(SOD) and reduced glutathione(GSH) were detected. Results Five weeks after injection of STZ, the body mass of the model group was firstly increased and then decreased, and FBG was increased(P<0.05 compared with the normal group). Compared with the normal group, FBG, TC, TG, LDL-C and INS levels were increased(P<0.01 or P<0.001), plasma NF-κB activity, TGF-β1 and SOD levels were enhanced, and GSH level was decreased in the model group, the difference being statistically significant (P<0.01 or P<0.001). Contrasted with the model group, FBG, TC, TG, LDL-C and INS levels in high-and low-dose Rhizoma Anemarrhenae extract group and in high-and low-dose Cortex Phellodendri extract group were decreased to various degrees. After continuous medication, plasma NF-κB activity and TGF-β1 and SOD levels in high-dose Rhizoma Anemarrhenae extract group and in high-dose Cortex Phellodendri extract group were reduced(P<0.05 or P<0.001), and plasma GSH level was increased(P<0.01). Conclusion Extract from raw materials of Rhizoma Anemarrhenae and Cortex Phellodendri has obvious hypoglycemic effect and protective effect on experimental mice with DPN.

Objective To investigate the change of levels of related cytokines,including transforming growth factor-β2 (TGF-β2),basic fibroblast growth factor (bFGF),platelet-derived growth factor (PDGF),interleukin-6 (IL-6),interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) and behavior in streptozotocin-induced diabetic rats between the before and after fracture,at the same time,to analyse the relativity of them.Methods The rat models of diabetic were induced by intraperitoneal injection of streptozotocin,which were divided into different diabetes mellitus group (DM group) randomly.The right tibiofibula of all the rats of diabetes mellitus group and normal control group(NC group) were broken,and then treated with external fixation.The bone callus formation was evaluated by X-ray.When all the operation above was completed,the rats were domesticated in different cages.The concentration of related cytokines of the DM groups and NC group was detected at different time.Results The behavior changes of diabetes fracture rats were distinct and appeared a series symptoms such as bradykinesia,dull,polydipsia,polyphage,polyuria,emaciated obviously.The concentration of related cytokines (TGFβ2,BFGF,PDGF,IL-6,IL-8 and TNF-α) of the two groups was detected at 1,2 and 4 weeks.The difference between them was significantly(TNF-α:the concentration of NC group were (9.87 ± 1.06) ng/ml,(14.07 ± 1.43)ng/ml and(12.02 ± 1.02) ng/ml; the concentration of DM group were (11.65 ± 1.18) ng/ml,(16.29 ± 1.24)ng/ml and(13.87 ± 1.25)ng/ml ; P ＜ 0.05).X-ray films showed that the fracture healing of NC group was more superior than that of DM group.Conclusion The reduction of TGF-β2,BFGF,PDGF and the increase of IL-6,IL-8,TNF-α in early fracture are one of important reasons for delayed union and nonunion in diabetic rats.At the same time,there is a cooperative action between them.Dynamic observation of the concentration of related cytokines will provide eliable experimental data to estimate fracture healing,delayed union and nonunion.It is favourable to acquaint the regulatory mechanism of fracture healing at molecular level.

Objective To establish assay methods for the determination of dissolution,content and related substances of vita-min K1 self-nanoemulsifying drug delivery system(VK1-SNEDDS),and investigate the physico-chemical properties of the preparation. Methods The UV method was established to determine the dissolution of VK1-SNEDDS. The content and related substances were de-termined by HPLC. The appearance,self-emulsification time,micro-morphology,droplet size and zeta potential were also investigat-ed. Results The linearity range of established UV and HPLC methods was 0.85-20.4 and 2.16-216μg/ml,respectively,and all the recovery,precision,specificity and sensitivity met requirements. VK1-SNEDDS could disperse quickly after dilution. The transmission electron microscope(TEM)image of the optimized liquid SNEDDS showed that most of the emulsion droplets were of uniform size with no signs of coalescence. Droplet size of optimal formulation was revealed as 47.74 nm with polydispersibility index(PDI)of 0.248,and zeta potential was found to be-20.53 mV. Conclusion VK1-SNEDDS could form homogeneous and stable nanoemulsion when dilut-ed with aqueous phase and increase the dissolution of lipophilic drug. The methods are reliable,accurate and suitable for quality con-trol of VK1-SNEDDS.

Objective To summarize the clinical experience of successful intervention in single chronic coronary actery total ocdusion (CTO) lesions by the transradial.Methods A retrospective analysis was conducted in 103 patients with single CTO lesions who got intervention treatment by the radial artery.Results ( 1 ) Of the 103 cases,57 cases had unstable angina,12 cases had stable angina,and 34 cases chronic myocardial infarction.Lesions' block time was ≤ 6 months in 83 cases,and ＞ 6 months in 20 cases.(2)The path vessels of the 103 patients have no severe tortuosity and anatomical structure variation.Fifty-one cases occurred left anterior descending occlusion,25 cases occurred left circumflex branches occlusion,and 27 cases occurred right coronary artery occlusion.Furthermore,24 cases had chronic complete occlusion,and 79 cases had chronic functional block.The side branches did not block in 91 cases,no lesions(bridge) collateral formation occurred in 87 cases,lesions length was less than 15 mm in 67 cases,and tapered lesions was observed in 81 cases.( 3 ) Final intervention rate via Judkins,XB,EBU guide catheter was 37.86％,30.10％ and 29.13％ respectively.(4)the PILOT successfully through the lesions for the series wire guided was 64.08％.(5) 1.25 mm diameter series with a balloon through the first lesions and successful expanding was observed in 57 cases (55.34％),and 1.5 mm diameter series with a balloon occurred in 38 cases(36.89％ ).Conclusion Intervention treatment by the radial of single CTO lesions is feasible for experienced performers.The successful intervention depends on path vessels unimpeded,target vessels with characteristic pathological features and reasonable choice of instruments.

Objective:To analyze the clinical efficacy of resection of anterior skull base meningiomas via neuroendoscopic supraorbital keyhole approach. Methods:Twelve patients with anterior skull base meningiomas resected via neuroendoscopic supraorbital keyhole approach in Department of Neurosurgery, Huaihe Hospital of He'nan University from May 2020 to May 2022 were chosen. A retrospective analysis was performed on the clinical data of these patients. Results:Postoperative brain enhanced MRI showed resection degree of Simpson grading Ⅰ in 2 patients and Simpson grading Ⅱ in 10 patients. Pathological examination indicated meningiomas in all patients. All patients were followed up for 3 months-2 years, and no cerebrospinal fluid leakage or endoscopy-related complications occurred. Among the 6 patients with preoperative vision and visual field changes, 4 patients got obviously improved and 2 patients got slightly improved. The 2 patients with blunt headache before surgery had completely normal symptoms. Of the 2 patients with preoperative hyposmia, one recovered to normal and the other one got slightly improved in symptoms.Conclusion:Resection of anterior skull base meningiomas via neuroendoscopic supraorbital keyhole approach can effectively improve resection rate, reduce complication incidence, and improve cure rate.

Objective To investigate the protective effects of dexmedetomidine on lung injury during one lung ventilation in patients undergoing lobectomia pulmonalis.Methods Sixty-four patients undergoing lobectomy in our hospital from May 2014 to February 2017 were selected.There were 38 males and 26 females,aged 42-75 years,ASA physical status Ⅱ or Ⅲ.Patients were divided into two groups according to different treatments,n=32 in each group.The patients in the observation group were given dexmedetomidine 0.5 μg· kg-1 · h-1 at 20 min before the induction of anesthesia,and adjusted to 0.2-0.5 μg·kg-1 ·h-1 after 10 min.The control group was given equal volume normal saline.The changes of polymorphonuclear neutrophil (PMN),myeloper oxidase (MPO),intra-pulmonary shunt rate(Qs/Qt),xanthine oxidase (XOD),vascular endothelial growth factor (VEGF) and nitric oxide (NO) concent ration were recorded at 10 min before induction (T0),beginning of OLV (T1),OLV for 60 min (T2),90 min (T3),postoperative 24 h (T4).Results Compared with T0,the PMN counts increased significantly at T2-T4 and the serum MPO and XOD concentrations were significantly increased (P＜0.05).The PMN counts,serum MPO and XOD concentration in the observation group were significantly lower than those in the control group (P＜0.05).Compared with T0,the serum VEGF concentration was significantly increased at T2 and T3,and the serum VEGF concentration in the observation group was significantly lower than that in control group at T3 (P＜0.05).The serum NO concentration at T2 and T3 in observation group was significantly higher than that in control group (P＜0.05).Conclusion Dexmedetomidine can reduce the inflammatory response of the lungs and has a protective effect on ischemia-reperfusion and injury in patients with single lung ventilation,and reduce the degree of oxidative stress,which plays a protective effect on lung.

The accuracy of preoperative staging diagnosis of colorectal cancer directly determines the accuracy of treatment and prognosis.Endoscopic ultrasonography,CT,MRI and positron emission tomography/computed tomography (PET/CT) imaging have their own advantages and disadvantages in preoperative staging of colorectal cancer.According to the actual situation of patients,choosing the best method of examination,when necessary,several effective methods combined,can improve the accuracy of preoperative staging diagnosis of colorectal cancer.