Objective To explore the treatment methods for brachial artery trauma associated with humeral super-middle fracture.Methods Thirty-two patients of brachial artery trauma associated with humeral super-middle fracture were treated in our department from March 2001 to April 2005 with in tramedallary expanded self-locking nail (IESN) combined with autotransplantation of great saphenous vein to repair brachial artery.Results All patients were followed up for 12 to 18 months,13.6 months on the average.No stenosis occurred at the anastomosed veins according to color Doppler ultrasound.All fractures achieyed clinical healing and the limbs survived well.Conclusion The IESN combined with autotransplantation of great saphenous vein to repair brachial artery is an effective method to treat brachial artery traumaassociated with humeral super-middle fracture,having the advantage of reasonable operation procedure.stabile immobilization and satisfactory functional recovery.

Objective To evaluate antibacterial activities of Cefoperazone-Sulbactam upon gram negative bacilli,and compare the differences in susceptibility between two different concentrations of Cefoperazone-Sulbactam combination disc.Method A total of 381 strains of commonly occurred gram negative bacilli were found from 2nd Affiliated Hospital of Zhejiang University School of Medicine,Zhejiang Provincial People's Hospital,The Third Hospital of Hangzhou and Hangzhou Hospital of Traditional Chinese Medicine respectively.Susceptibility test was conducted by K-B method using 75 μg/disc Cefoperazone plus with 75 μg/disc Sulbactam(150 disc)and 75 μg/disc Cefoperazone with 30 μg/disc Sulbactam(105 disc),respectively.Meanwhile the minimal inhibitory concentration(MIC)of Cefoperazone-Sulbactam was determined by standard agar dilution.The data were analyzed by using WHONET 5.4 and SPSS.Results Disc diffusion method was carried out to detect the antibacterial activities upon Escherichia coli,Klebsiella pneumonia,Pseudomonas aeruginosa and Acinetobacter baumannii,using 105 disc and 150 disc,respectively.The data indicated that consistency rates between these two different discs were 26.3%,79.2%,83.7%and 33%,respectively.The k-related sample test was performed by using SPSS version 10.0 and shown that the P value was less than 0.05.Upon those organisms mentioned above,the consistency rates between the antibacterial activities of 105 disc and those of agar dilution were 77.8%,89.6%,70.9%and 77%,respectively.When it was going to compare agar dilution vs.150 disc upon the susceptibility of those organisms the consistency rates were 27.3%,79.2%,61.6%and 30%,respectively.Compared with agar dilution,the error rates of those two different concentration discs revealed that the false susceptibility and false intermediate of 105 disc were higher than those of 105 disc.ConclusionsThe results of susceptibility test showed that 105 disc was more close to agar dilution than that of 150 disc.However,the 150 disc used in clinic led to increase in sensitivity of susceptibility test to organisms.

Objective To evaluate the effects of Miseq FGx sequencing system for degraded bone sample testing. Methods Ten degraded bone samples that produced unsatisfactory STR typing with PCR-CE were tested using Miseq FGx, so as to compare the detection result and detection rate of the STR loci between the two systems. Results The detection rates of all the STR loci were higher with MiSeq FGx than with PCR-CE; some of the STR loci that might have not been detectable with PCR-CE were probably detectable with Miseq FGx. Sequencing with Miseq FGx also provided abundant information on the genetic markers including X-STR, Y-STR and SNP. Conclusion MiSeq FGx presents high application value for degraded bone sample testing.

BACKGROUND:Which an ideal method to treat type Rockwood Ⅲ acromioclavicular joint dislocation is,traditional or surgical therapy,is still controversial.OBJECTIVE:To investigate the clinical effect of clavicular hook plate implantation on type Rockwood Ⅲ acromioclayicular joint dislocation.METHODS:A total of 56 patients with type Rockwood Ⅲ acromioclavicular joint dislocation were selected from Department of Orthopaedics of Yiling Hospital between December 2005 and June 2008.There were 42 males and 14 females,aged 16-65 years and mean age of 32 years.All patients were treated with clavicular hook plate implantation.Indicators including visual analogue scale (VAS),the United States shoulder and elbow surgeon score (ASES),and Constant and Murley scoring system were tested pre-operatively,one year postoperatively,before internal fixation,and 3 months after internal fixation;additionally,functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation.RESULTS AND CONCLUSION:The surgery and following-up were successfully achieved in 56 cases.The following-up lasted for 15-30 months,with the mean time of 20 months.The internal fixation was taken out at about 1 year after implantation.Coracoclavicular ligament was repaired in 32 cases but not in the 24 cases.Two patients with acromioclavicular joint dislocation recurrence were excluded,and coracoclavicular ligament therapy was not performed.Shoulder pain,foreign body sensation,and internal fixation failure occurred in two cases.One year after operation,VAS was decreased compared with that before operation,but ASES and Constant and Murley score were significantly increased (P＜0.01).At three months after internal fixation,VAS was decreased compared with that at 1 year after operation,but ASES and Constant and Murley score were increased (P＜0.05).The results demonstrated that clavicular hook plate implantation for treating type Rockwood Ⅲ acromioclavicular joint dislocation is simple and less invasive,thus it is an ideal internal fixation.

Objective To understand the relationship between MTHFR 677C/T polymorphism and general status of pregnant women and offspring congenital heart disease (CHD).Methods A case-control study was conducted among the biological mothers of 100 infants with CHD and 100 healthy controls to collect the information about their demographic characteristics,general status during pregnancy and awareness of eugenics.Their MTHFR 677C/T polymorphism and serum homocysteine (HCY),folic acid,vitamin B12 levels were detected.Results The differences in MTHFR genotype and allele frequency between the two groups were not statistical significant (x2=1.08,P=0.582;x2=0.53,P=0.468),but the difference in serum HCY between two groups were statistical significant (t=-8.14,P=0.000).Univariate analysis showed that 14 factors had statistical significances (P＜0.05).Multivariate logistic regression analysis indicated that mother's educational level(OR=3.386,95％ CI:1.279-8.961),annual household income (OR =8.699,95％ CI:2.177-34.765),chronic disease prevalence (OR=0.343,95％ CI:0.134-0.881),awareness of eugenics (OR=0.906,95％ CI:0.836-0.981),serum HCY level(OR=1.734,95％CI:1.458-1.986) and abnormal reproductive history(OR=3.710,95％ CI:1.217-11.308) were correlated with offspring CHD.Conclusion There was no correlation between MTHFR 677C/T polymorphism of pregnant women and offspring CHD,but low educational level,low annual household income,abnormal reproductive history,low awareness of eugenics and high serum HCY levels of pregnant women might increase the risk of offspring CHD.

Objective:To develop a grading prediction model of traumatic hemorrhage volume based on deep learning and assist in predicting traumatic hemorrhage volume.Methods:A retrospective observational study was conducted based on the experimental data of pig gunshot wounds in the time-effect assessment database for experiments on war-traumatized animals constructed by the General Hospital of the Chinese People's Liberation Army. The hemorrhage volume data of the study population were extracted, and the animals were divided into 0-300 mL, 301-600 mL, and > 600 mL groups according to the hemorrhage volume. Using vital signs indexes as the predictive variables and hemorrhage volume grading as the outcome variable, trauma hemorrhage volume grading prediction models were developed based on four traditional machine learning and ten deep learning methods. Using laboratory test indexes as predictive variables and hemorrhage volume grading as outcome variables, trauma hemorrhage volume grading prediction models were developed based on the above fourteen methods. The effect of the two groups of models was evaluated by accuracy and area under the receiver operator characteristic curve (AUC), and the optimal models in the two groups were mixed to obtain hybrid model 1. Feature selection was conducted according to the genetic algorithm, and hybrid model 2 was constructed according to the best feature combination. Finally, hybrid model 2 was deployed in the animal experiment database system.Results:Ninety-six traumatic animals in the database were enrolled, including 27 pigs in the 0-300 mL group, 40 in the 301-600 mL group, and 29 in the > 600 mL group. Among the fourteen models based on vital signs indexes, fully convolutional network (FCN) model was the best [accuracy: 60.0%, AUC and 95% confidence interval (95% CI) was 0.699 (0.671-0.727)]. Among the fourteen models based on laboratory test indexes, recurrent neural network (RNN) model was the best [accuracy: 68.9%, AUC (95% CI) was 0.845 (0.829-0.860)]. After mixing the FCN and RNN models, the hybrid model 1, namely RNN-FCN model was obtained, and the performance of the model was improved [accuracy: 74.2%, AUC (95% CI) was 0.847 (0.833-0.862)]. Feature selection was carried out by genetic algorithm, and the hybrid model 2, namely RNN-FCN* model, was constructed according to the selected feature combination, which further improved the model performance [accuracy: 80.5%, AUC (95% CI) was 0.880 (0.868-0.893)]. The hybrid model 2 contained ten indexes, including mean arterial pressure (MAP), hematocrit (HCT), platelet count (PLT), lactic acid, arterial partial pressure of carbon dioxide (PaCO 2), Total CO 2, blood sodium, anion gap (AG), fibrinogen (FIB), international normalized ratio (INR). Finally, the RNN-FCN* model was deployed in the database system, which realized automatic, continuous, efficient, intelligent, and grading prediction of hemorrhage volume in traumatic animals. Conclusion:Based on deep learning, a grading prediction model of traumatic hemorrhage volume was developed and deployed in the information system to realize the intelligent grading prediction of traumatic animal hemorrhage volume.

Objective:To analyze the influencing factors and improvement paths of the cultivation of full-time doctoral scientific and technological innovation ability in large public hospitals, and propose countermeasures and suggestions.Methods:This studyed conducted a survey and analysis of 122 doctors from Linyi People′s Hospital in Shandong Province, and completed a current situation study based on the analysis results.Results:There was no significant difference between the two groups in gender, age, degree type, professional category, discipline level, Graduate School type, job type and other indicators. There were significant differences between the two groups in scientific research topic selection ability score, project design ability score, data analysis ability score, data interpretation ability score, project approval in recent 5 years, project level, number of SCI journal papers published in recent 5 years, cumulative impact factors of SCI journal papers, and annual number of academic activities ( P<0.05). Conclusions:The hospital can improve the scientific and technological innovation ability of full-time doctors by setting up a special cultivation plan, establishing an interdisciplinary team, optimizing scientific research management services, improving the evaluation and assessment system, and improving welfare protection.

OBJECTIVETo study the effects of emodin on proliferation and differentiation of 3T3-L1 preadipocyte and the possible mechanism.

METHODSCell proliferation was determined by MTT spectrophotometry, cell differentiation was determined by Oil Red O staining,and fatty acid synthase (FAS) activity was determined by spectrophotometry.

RESULTSEmodin promoted proliferation of 3T3-L1 preadipocyte at low concentration and inhibited the proliferation at high concentration in a dose-related manner. In contrast, it inhibited cell differentiation into adipocyte at low concentration in a dose-related manner. In vitro emodin inhibited the activity of FAS in a dose-related manner.

CONCLUSIONSThe effects of emodin on 3T3-L1 cell's proliferation and differentiation are dose dependent. Emodin inhibits the activity of FAS. Our results suggest that emodin should have a potential to serve as a fat-reducing drug.

3T3 Cells ; Adipocytes ; drug effects ; physiology ; Animals ; Cell Differentiation ; drug effects ; Cell Division ; drug effects ; Emodin ; pharmacology ; Fatty Acid Synthases ; antagonists & inhibitors ; Lipid Metabolism ; Mice ; Stem Cells ; drug effects ; physiology

Objective To explore the status-quo and possible constraints of scientific research in a municipal public hospital,provide countermeasures for the improvement of scientific research administration capacity.Methods Questionnaire survey was conducted to 1 356 medical staff in a tertiary hospital in Zhejiang province,information collected including the statusquo of scientific research,attitude towards scientific research,difficulties and suggestions.Results Among 1 316 valid questionnaires,61 ％ of the respondents agreed that scientific research was very important for the development of hospitals,83 ％ of the respondents were willing to use their spare time to conduct scientific research projects,and 61.2％ of them usually had plans to do research but did not know where to start.The main constraints identified were the poor academic atmosphere,lack of scientific research training,and lack of scientific research facilities and resources.Conclusions The medical staffs in a municipal public hospital have high subjective enthusiasm for scientific research,low personal research ability and poor research environment.It is suggested to improve the scientific research ability of the staff on the basis of improving the objective environmental conditions for research.

Objective:To understand the willingness of pre-exposure prophylaxis (PrEP) use to prevent HIV infection and related factors in men who have sex with men (MSM) in Yunnan Province.Methods:Cross-sectional study method and snowball sampling method was used to carry out the survey in 14 cities (autonomous prefectures) in Yunnan from April to June 2021. According to national sentinel surveillance program, the sample size was 400 at national sentinel sites and 100 at provincial sentinel sites. The related factors of PrEP use willingness were analyzed by multiple logistic regressions with software SPSS 22.0.Results:A total of 2 450 questionnaires were completed, the rate of having heard of PrEP was 68.5% (1 677/2 449), the willingness rate of PrEP use was 56.7% (1 343/2 368), the willing rate of PrEP use at their own expense was 30.6% (724/2 368), and the willingness rate of free PrEP use was 56.2% (1 330/2 367). The of multivariate logistic analysis results showed that related factors of low willingness to use PrEP included aged 40-49 years and 50 years or above (a OR=2.49 and a OR=4.48), Han ethnic group (a OR=1.47), residence in other provinces (a OR=1.64), education level of senior high school (a OR=1.96) and college or above (a OR=3.49), sample source of bath house (a OR=3.53), online recruiting (a OR=2.53) and voluntary counseling and testing (a OR=1.42), local living time for 3-6 months and 7-12 months (a OR=0.18 and a OR=0.25) ,class 2 and 3 of survey areas (a OR=3.63 and a OR=1.71), having no anal sex with men in the past week (a OR=2.60), having no commercial homosexual behavior in the past six months (a OR=13.32) and self-perceived higer risk for HIV infection (a OR=0.50). Conclusions:There was more than half of MSM with willingness to use PrEP. The health education to promote PrEP use should be strengthen in MSM who had low willingness to use PrEP from underdeveloped areas, in Han ethnic group, with older age, from other provinces, with shorter local living time and self-perceived low risk for HIV infection.