[Objective]To research the biomechanical influence of posteriomedial fractures on proximal femur.[Method]Three dimensional finite element models of intact and osteotomied proximal femurs were established from computerized tomographic(CT)scanning images,and finite element analysis was undertaken.[Result]The maximum equivalent stress was located at the anteriomedial of the defection of the proximal femur.The stress of femoral neck,as well as the medial and lateral femoral cortex was not significantly changed after isolated lesser trochanteric fracture.However,with half of the medial cortex involved,the stress of the medial and lateral femur increased by 47% and 12%,respectively.If the entire medial cortex was involved,the stress of medial and lateral femur increased by 247% and 66%,respectively.[Conclusion]Different types of posteriomedial fragments have different effects on the stress distribution and quantity of proximal femur.When treating intertrochanteric fractures using dynamical hip screw,the fragments should be differently treated based on its types considering for biomechanical effects.

Background:As the incidence of acute pancreatitis( AP)is increasing and the mortality remains high,early identification and early intervention of patients at risk of severe acute pancreatitis(SAP)is of great clinical significance. Aims:To investigate the value of commonly used AP-related serum biochemical markers for early prediction of severity of AP. Methods:Retrospective analysis was performed in 205 AP patients in Renmin Hospital of Wuhan University from Jan. 2014 to Dec. 2014,and 92 healthy subjects were served as controls. Patients with AP were divided into mild(n = 92), moderately severe(n = 72)and severe AP(n = 41)groups. The demographic characteristics,history of chronic diseases, serum biochemical markers within 48 hours after admission,Ranson score,BISAP score and other related clinical data were collected and compared between the four groups. The diagnostic performance of these indices in predicting SAP was evaluated by ROC curve,and the correlation of these indices with SAP was assessed by Logistic regression analysis. Results:There were significant differences in Ranson score,BISAP score,D-dimer,blood calcium,procalcitonin(PCT), CRP,hypersensitive CRP(HS-CRP),triacylglycerol and blood glucose between the four groups(P < 0. 05). The area under curve(AUC)of blood calcium was 0. 838 for early prediction of SAP,which was second to that of Ranson score and BISAP score. The accuracies of PCT and D-dimer were acceptable but inferior to blood calcium,while the accuracies of other indices were considerably low. Logistic regression analysis revealed that the odds ratio of risk for SAP of Ranson score,PCT and HS-CRP were all greater than 1 000,while that of blood calcium and D-dimer were 0. 013 and 19. 479, respectively. Conclusions:Of the AP-related serum biochemical markers,blood calcium,D-dimer and PCT are the preferred early predictors for severity of AP.

Background:Acute kidney injury(AKI)is one of the early serious complications of acute pancreatitis(AP). Early identification and intervention have important clinical significance. Aims:To investigate the early predictive value of clinical indicators found within 48 hours after admission for AKI in patients with AP. Methods:A retrospective analysis of 205 AP patients from January 2014 to December 2014 at Renmin Hospital of Wuhan University was performed. AP patients were divided into AKI group and non-AKI group according to the KDIGO standard,the demographic characteristics,history of chronic diseases and indicators defined within 48 hours after admission such as Ranson score,BISAP score and biochemical indices were compared. The early predictive value of clinical indicators for AKI was evaluted,and strength of association between clinical indicators and AKI was assessed. Results:Compared with non-AKI group,Ranson score, BISAP score,D-dimer,PCT,blood glucose,triacylglycerol were significantly increased in AKI group(P < 0. 05),and calcium was significantly decreased(P < 0. 05). The accuracies of D-dimer,PCT,calcium were high for early prediction of AKI,and the AUC were 0. 881,0. 803 and 0. 782,respectively. Logistic regression analysis showed that D-dimer, PCT,calcium had marked correlation with AKI(OR all > 7)(P < 0. 05). Conclusions:D-dimer,PCT and calcium are effective and economical clinical indicators for the early prediction of AKI in patients with AP.

BACKGROUND: Modified banxia houpu decoction (MBHD) is one of thefamous methods and has been used by Zhang Zhong-jin to treat emotionaldiseases in Han dynasty, and it has been used till now. It can be used totreat depression, anxiety, phychoneurosis and so on.OBJECTIVE: To observe the therapeutic effect of MBHD on treatingheroin abusers with protracted abstinence syndrome and compare the effectwith brown sugar water.DESIGN: Randomized grouping and placebo randomized controlled study.SETTING: School of Medicine, Hubei Institute for Nationalities and theAbstinence Institute of Public Security Bureau of Enshi AutonomousPrepecture.PARTICIPANTS: Totally 187 cases were the abusers of heroin who hadbeen forced to abstinence in the Abstinence Institute of Public SecurityBureau of Enshi Autonomous Prepecture from August 2000 to September2002. There were 101 males and 86 females aged 18-44 years. All pa-tients were known the fact and were randomly divided into control group(n=58), 60-day MBHD group (n=62) and 72-MBHD group (n=67) accordingto double-blind method.METHODS: ① During the abstinence, three groups were treated bylofexidine hydrochloride (LFX) which was produced by the LimitedCompany of Zhengtai Pharmaceuticals Enterprise of Hunan Province (lotnumber: 990619, 10 mg/pill) for 12 days, then they were treated sepa-rated. Give medicine to 60-MBHD group continuously for 60 days (MB-HD: Pinellia Ternate 15 g, Magnolia Bark 30 g, Poria Cocos 20 g, Perilla10 g, Ginger 20 g, Radix Acanthopanacis Senticosi 20 g, Pericarpium CitriReticulate 6 g, Pericarpium Arecae 20 g, Herba Agastachis 10 g. Tradi-tional Chinese medicines were all bought from HuBei Medicine Company;three times a day, one portion for two days), gave the control group red sug-ar water imitate medicine for 60 days (the method was the same as above),72-MBHD group were given the same quantity of MBHD as 60-MBHDgroup when LFX began to detoxifieate, the whole time was 72 days (Thetime before LFX treat 12 days and after 60 days). It took 72 days for thethree groups to be treated by LFX according to single-blind method. ②Heroin protracted abstinence syndrome scale: insomnia, pain syndromes,catarrh syndromes, mental conditions and sexual function. They werescored respectively to 1, 2, 3 according to mild, moderate and severe.③ One year tater collected the urina sanguinis (three times a week con-tinuously) regarded the positive as re-abusers. ④ Measurement andenumeration data were compared with t test and x2 test respectively.MAIN OUTCOME MEASURES: ① Scores of protracted abstinencesyndrome; ② Comparisons of drug re-abusing rate within one year.RESULTS: Totally 187 heroin-dependence patients entered the finalanalysis. ① Scores of protracted abstinence syndrome were lower in 60-day MBHD group and 72-day MBHD group than those in control group(P ＜ 0.01). Scores of pain and catarrh symptoms in 72-day MBHD group were similar to those in 60-day MBHD group (P ＞ 0.05), but scores of insomnia, mental conditions and sexual function were lower than those in 60-day MBHD group (P ＜ 0.01). ② Drug re-abusing rate within one year was lower in 72-day MBHD group than that in control group and 60-day MBHD group [73% (49/67), 95% (55/58), 82% (51/62),P ＜ 0.05],but rate in 60-day MBHD group was similar to that in control group (P ＞ 0.05).CONCLUSION: MBHD can improve the protracted abstinence symptoms of heroin abusers after detoxification. In spite of the complexity of various factors, to effectively control the early stage abstinence symptoms and median stage protracted abstinence symptoms is one of the effective measures to prevent drug re-abusing.

Objective: To observe the efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain.Methods: A total of 106 patients with chronic ankle sprain were included in the study. They were numbered according to their order of visit, with odd numbers assigned to the control group and even numbers assigned to the observation group, with 53 cases in each group. Patients in the control group were treated with Maitland ankle mobilization, while those in the observation group were given additional contralateral needling treatment. After treatment, we observed the indicators including, ankle circumference, range of motion (ROM) of dorsiflexion, ROM of plantar flexion, thickness of ankle ligaments, and the changes in Baird-Jackson ankle score, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and visual analog scale (VAS) score to compare the efficacy between the two groups. Results: After treatment, the total effective rate of the observation group was 94.3％ and was significantly higher than that of the control group (81.1％), indicating statistical significance (P<0.05). After treatment, the ankle circumference of both groups decreased, and the ROM of dorsiflexion and the ROM of plantar flexion increased (P<0.05). The changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the thickness of the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament, as well as the VAS scores decreased in both groups; the changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the Baird-Jackson ankle score and the AOFAS ankle- hindfoot score increased in both groups, and the scores in the observation group were higher than those in the control group, indicating inter-group statistical significance (P<0.05). Conclusion: The efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain is superior to that of Maitland ankle mobilization alone.

Objective To establish an RP-HPLC method for determining serum level of valproate.Methods A symmetryshield RP18 column (5?m,3.9mm?150mm) was used.The mobile phase,methanol-water(80:20) was used at a flow rate of 1.0ml/min.The detector was Waters 2487 dual?absorbance detector,which was set at the wavelength of 248nm.Serum sample was extracted with 2ml acetic n-hexane,then valproic acid in organic layer was derived by adding into?-bromoacetophenone,and cyclohcxanecarboxyiic acid was selected as an internal stan- dard.Results The calibration curve was linear in the range of 5.0 to 250.0vtg/ml.The average recovery rate was 98.23%,and the RSD within-day and between-day were both less than 3 %.Conclusion This method is suitable for therapeutic drug monitoring of phenytoin.

Objective To explore the effect of early systemic phased exercise post mastectomy on the recovery of activities of daily living. Methods 100 patients who received modified radical mastectomy were assigned to the experimental group and control group with 50 patients in each group. They all accepted routine nursing, and the experimental group accepted early systemic phased exercise in addition. They were assessed with range of motion (ROM) of shoulder and modified Barthel Index (MBI). Results ROM of shoulder improved in 90% of the experimental group and 70% of the control group (P<0.05). MBI was (84.5±18.2) in the experimental group and (51.8±16.6) in control group (P<0.05) . Conclusion Early systemic phased exercises may promote the recovery of the affected arm for the patients post mastectomy.

Objective To study the effect of pulse pressure(PP)/mean artery pressure(MAP) ratio in evaluating arteriosclerosis.Methods Blood pressures from 200 subjects without cerebrovascular nor cardiovascular disease were obtained and analyzed by different age groups.PP/MAP ratio was calculated for each patient and compared.Results PP/MAP ratio was significantly different in different age groups.Conclusion PP/MAP ratio has clinical significance in evaluating arteriosclerosis and is worthy of further investigation.

Objective To explore the use of integrated two methods in vitro in prediction of eye irritation caused by cosmetics.Method Chorioallantoic membrane vascular assay ( CAMVA), bovine corneal opacity and permeability (BCOP) and Draize rabbit eye irritation test were used to determine the predictive potential of eye irritation of 60 kinds of cosmetics.Results CAMVA method was able to distinguish 41 non-irritant samples and 18 irritant samples.BCOP method was able to predict 35 non-irritant samples , 21 mild-moderate irritant samples and 4 severe irritant samples . Combination of CAMVA and BCOP methods could obviously improve the identification ability of irritation , and the classification consistency with Draize rabbit eye irritation testing reached 98.3%.Conclusions The integrated test strategy combined BCOP with CAMVA can be used to appropriately predict ocular irritation of cosmetics , with a prediction range covering non-irritant to severe irritant samples .