Objective To investigate the treatment of nonunion and cubitus varus after lateral condylar fracture of humerus. Methods 5 cases of nonunion and cubitus varus after lateral condylar fracture of humerus were admitted to my department from January 2001 to June 2003. They were treated with reduction and supracondylar wedge osteotomy. Results They were followed up for 8 months on average. Their nonunion and cubitus varus were all corrected. According to Su Shang-qing’s evaluation system, 4 cases achieved excellent results and 1 good. Conclusion The operative management is simple and effective for nonunion and cubitus varus after lateral condylar fracture of humerus.

BACKGROUND:Great saphenous vein is the most common vascular material in coronary artery bypass grafting, however, the graft neointimal hyperplasia and subsequent atherosclerosis result in angiostegnosis, which affect the long-term efficacy. OBJECTIVE: To analyze the pathophysiology and mechanism of the angiostenosis, additionally, to construct smooth muscle cell specific SM22a promoter and SMHC enhancer. METHODS: The database of PubMed, HighWire and CNKI were retrieved with key words of "SM22α promoter, SMHC enhancer, stenosis, Pi3k and RNAi/RNA interference". The language was confined to English and Chinese. The literatures correlated with angiostenosis, VSMC-specific SM22α promoter and enhancer were selected. The reviews and overlapped researches were excluded. In vascular smooth muscle cell proliferation and apoptosis of graft neointimal hyperplasia, as well as the extent of graft thrombosis were considered as evaluation index. RESULTS AND CONCLUSION: More than 8 730 literatures were searched by the computer. According to inclusion and exclusion criteria, the SM22α promoter and angiostenosis were analyzed. The neointimal hyperplasia and thrombosis had a strong impact on prospective efficacy after coronary artery bypass grafting. The PI3K-Akt-mTOR pathway was a crucial signal passage which regulated cell proliferation and migration. RNA interference targeting Pik3cb can efficiently suppress the neointimal hyperplasia through down regulating the PI3K-Akt-mTOR pathway. The shRNA eukaryon expression plasmid vectors targeting rat Pik3cb were constructed using VSMC-specific SM22α promoter. On the one hand, it can suppress the neointimal hyperplasia, and on the other, it can prevent the occurrence of thrombosis.SM22a is a specific gene in vascular smooth muscle cell. The studies that applied VSMC-specific SM22α promoter/enhancer to vascular grafting provide a new strategy to prevent angiostenosis and thrombosis.

OBJECTIVE:To investigate the way of implementing quantized assessme nt in department of pharmacy METHODS:To set up the general quantized indexes of pharmacy and splitting indexes of various sections RESULTS:By way of quantize d assessment,the enthusiasm of staff members was aroused and the quality of pha rmaceutical service improved CONCLUSION:Implementing quantized assessment make s the realization of scientific management of pharmacy

Objective To discuss the efficacy of micro-diameter and multiple-drilling core decompression in treatment of early femur head necrosis. Methods Sixty-eight patients with early femur head necrosis were selected, and they were divided into 2 groups by random digits table method. The experiment group (35 cases) underwent the micro-diameter and multiple-drilling core decompression (3.0-4.0 mm Kirschner wire or drill), and the control group (33 cases) underwent traditional instruments surgery. Results The operative time, hospital stay and pain score of postoperative hip joint Harris score in experiment group were better than those in control group:(41.2±7.4) min vs. (74.3±10.2) min, (9.7±2.3) d vs. (14.3±4.2) d and (43.56±2.12) scores vs. (37.21±1.19) scores, and there were statistical differences (P<0.01 or<0.05). There were no statistical differences in blood loss and overall hospital costs between 2 groups (P>0.05). There were no statistical differences in the total score of hip joint Harris score at 3 and 6 months after surgery (P>0.05). The total scores of hip joint Harris score at 12 and 24 month after surgery in experiment group were significantly higher than those in control group:(93.11± 2.43) scores vs. (91.23±2.89) scores and (85.23±2.43) scores vs. (73.54±2.89) scores, and there were statistical differences (P<0.05). Conclusions The micro-diameter and multiple-drilling core decompression is applied to the early femur head necrosis with less trauma, shorter operative time, higher clearance rate of necrotic bone and slower disease progression compared with traditional instruments. The micro-diameter and multiple-drilling core decompression makes patients' hip function get a satisfactory recovery with certain clinical applications.

[Objective]To study the degradation of nano-nacre powder and the biocompatibility of the composite artificial bone made from this nano-scale powder in vivo.[Method]The nano-nacre powder made through mechanical grinding and the artificial bones made from this powder and PDLLA(poly-D,L-lactide acid) were implanted into the femoral holes and the femoral muscle sacs of rats respectively.Normal micron-nacre powder and the artificial bones made from this powder and PDLLA were implanted as control group,and blank group was set up without implanting anything.X-ray photography was performed immediately and at 2,4 and 8 weeks after operation.The animals were injected with tetracycline for fluorescent mark before being killed.Then,the gross specimens,histological and SEM(scanning electron microscope) observations were performed.[Result]All the observations showed that nano-nacre powder degraded faster than micron-nacre powder,meanwhile,the bone defect recovery was the fastest in this group.Both of the composite artificial bones made from those two kinds of nacre powder had the good connection with the adjacent tissue.[Conclusion]The degradation of nano-nacre powder is faster than that of micron-nacre powder in vivo,and it can promote the growing of new bone.Nano-nacre composite artificial bone also has good biocompatibility.It is a kind of better bioactive degradable material.

OBJECTIVE:To investigate the use of antibiotics in the inpatients of our hospital.METHODS:The medical records of inpatients from Jan.2004 to Dec.2006 randomly selected in our hospital were analyzed statistically in respect to the irrational use of antibiotics.RESULTS:Of the total 1,120 inpatient medical records examined,843(75.3%) used antibiotics,56 involved irrational use of antibiotics,which manifested as improper in dosage,dosage regimen,drug combination or solvents selection etc.CONCLUSION:The irrational use of antibiotics is quite common,thus the role of clinical pharmacists should be strengthened to promote rational use of antibiotics in clinical practice.

OBJECTIVE:To prepare Xiaozhong zhitong cataplasma,establish a method for its quality control and to observe its clinical efficacy on orthopedic patients(30 cases).METHODS:Based on the precompounded prescription order of Xiaozhong zhitong powder with water soluble polymer substance as base material which were evenly mixed with the drug extractives before being applied on non-woven fabric to prepare Xiaozhong zhitong cataplasma.The clinical efficacy was compared between the trial group(Xiaozhong zhitong cataplasma) and the control group(Xiaozhong zhitong powder).RESULTS:The prepared Xiaozhong zhitong cataplasma had smooth surface and uniform thickness,with a satisfactory stability achieved within 3 months at a dosage of 0.715 6 g?100 cm-2.The total effective rate in the trial group(93.3%) was significantly higher than in the control group(76.7%)(P

Objective To study the relationship between essential hypertension(EH)with serum homocysteine(HCY),uroten-sinⅡ(UⅡ),angiotensin converting enzyme(ACE)and N-terminal pro-brain natriuretic peptide(NT-proBNP).Methods By collec-ting the clinical cases,UⅡwas determined by ELISA and HCY,ACE and NT-proBNP were simultaneously detected by ELISA.The detection results were analyzed and compared between the patients with essential hypertension(EH group)and the healthy con-trols.Results The levels of serum HCY,UⅡ,ACE and NT-proBNP in the EH group were significantly increased compared with the healthy control group;the area under curve (AUC)of serum HCY,UⅡ,ACE and NT-proBNP in the ROC curve in the EH group were 0.93,0.765,0.792 and 0.972 respectively,which showed clinical diagnostic significance.Conclusion The levels of HCY,UⅡ,ACE and NT-proBNP are highly expressed in EH and have significant differences compared with the healthy popula-tion,which has the diagnostic value to EH.

Objective: To observe the short-term effects of electroacupuncture at different acupoints on patients with hemiplegia after cerebral infarction. Methods: Patients with cerebral infarction were randomly allocated into a group of electroacupuncture nerve trunk and a group nerve trunk or routine acupoints, respectively, once a day, for 14 d. Results: Electroacupuncture at nerve trunk had better effects than at routine acupoints. The short-term improvement of electroencephalogram had significant differences (P＜0.05). Conclusion: Electroacupuncture at the nerve trunk could improve the neurologic impairment and brain function, and it has a better result than routine electroacupuncture.

Objective To evaluate the effects of perioperative probiotics administration on patients with colorectal cancer and to explore its possible mechanism.Methods Seventy patients with colorectal cancer who were scheduled to undergo radical colorectomy at Shanghai Sixth People's Hospital between May 2011 and July 2011 were randomly divided with random number table into the control group (n =35) and the treatment group (n =35).The two groups in 5 days preoperatively and 7 days postoperatively were given daily doses of probiotics preparation consisting of two combined live bacteria and placebo,respectively.The structure of intestinal epithelial tight junction was observed by electron microscopy in colorectal tissue specimens collected during the operation.The expression of tight junctional protein was detected using Western blot and real-time RT-PCR technology.Intestinal epithelial permeability was evaluated by Ussing Chamber system.Stool samples and blood samples were collected on the 7th day after operation.The diversity of faecal flora was analyzed by terminal restriction fragment length polymorphism (T-RFLP) technique,and the quantitative detection of specific bacteria was conducted by bacterial culture.Clinical parameters including the first exhaust and defecate time,distension and diarrhea incidence,systemic inflammatory response,and postoperative infective complications were recorded.Results Compared with the control group,the treatment group showed better intestinal epithelial tight junction ultrastructure.The expression of tight junction proteins occludin,claudin-1,and ZO-1 (protein:all P ＜ 0.001 ; mRNA:P =0.005,0.001,0.006) and the transepithelial electrical resistance [(28.3 ±5.2) Ω · cm2 vs.(22.1 ± 4.7) Ω · cm2,P =0.002] were significantly increased,the large molecule permeability [(0.91 ± 0.17) ％ vs.(1.65 ± 0.33) ％,P ＜ 0.001] reduced,the diversity of intestinal flora (P=0.006) increased,the growth of intestinal Bifidobacteria [(143.4 ±35.9) vs.(100.0 ±0.0),P=0.002] and Lactobacilli [(111.3 ± 52.9) vs.(100.0 ± 0.0),P ＜ 0.001] promoted,and the growth of Clostridium perfringens [(66.2 ±23.7) vs.(100.0 ±0.0),P ＜0.001] inhibited in the treatment group.The treatment group also showed shorter postoperative exhaust [(2.5 ± 1.7) d vs.(4.5 ±2.0) d,P ＜0.001] and defecate time [(5.0 ± 1.3) d vs.(6.3 ± 1.1) d,P =0.002],lower incidence of diarrhea (20％ vs.40％,P =0.005) and abdominal distension (35 ％ vs.60％,P =0.021).Conclusion Probiotics used perioperatively in patients with colorectal cancer can effectively enhance the intestinal epithelia barrier function,maintain the homeostasis of gut flora,shorten the postoperative first exhaust and defecate time,reduce the incidence of diarrhea and abdominal distension,and promote the recovery of intestinal function.