OBJECTIVETo evaluate the clinical effect of a new surgical approaches for repairing the acute Achilles tendon rupture.

METHODSFrom January 2009 to January 2014, 21 patients with Achilles tendon rupture were treated by 2 minimally invasive incisions and remaining skin bridge of achilles tendon end including 16 males and 5 females with an average age of 44.3 years old ranging from 21 to 57 years old. Postoperative complications, the range of movement of affected ankle joint, the circumference calf and ankle on both side, time of reture to work and sports activity were observed and recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate the functional recovery.

RESULTSAll patients were followed up for 6 to 36 months with an average of 13.5 months. No skin necrosis, wound infection, deep vein thrombosis,re-rupture and sensory disturbance with the ankle or foot in the sural nerve distribution were found. At 1 year after operation, there was no significant difference in the range of movement between affected foot (55.4 ± 6.5)° and unaffected foot (56.3 ± 3.7)° (t = 0.872, P = 0.325). There was significant difference in AOFAS between preoperative (65.1 ± 6.9) and postoperative (94.3 ± 5.5) (t = 7.672, P = 0.013). All patients returned to work and study at an average of 10 weeks (ranged from 6 to 15 weeks) and 15 patients returned to normal sports activities at 21 weeks (ranged from 18 to 24 weeks). Calf and ankle circumferences decreased by 0.45 cm (0.3 to 0.8 cm) and increased by 0.4 cm (0.2 to 0.7 cm), respectively in the injured leg as compared with the contralateral leg.

CONCLUSIONThe simplicity of the technique of minimally invasive incision and skin bridge for acute closed Achilles tendon reconstruction is an effective and reliable method with low complication.

Achilles Tendon ; surgery ; Acute Disease ; Adult ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Rupture

Objective To investigate the changes of expressions of axon guidance molecule Sema3F and its receptor Np2 in hippocampus of temporal lobe epilepsy(TLE)rat.Methods Rats were injected with Lithium-chloride,Pilocarpine intraperitoneally to establish TLE model.The Sema3F mRNA,Np2 mRNA and protein in areas CA1,CA3 and dentate gyrus(DG)of hippocampus at different time were detected by immunohistochemistry and in situ hybridization for TLE models.Further,they were compared with normal control group.Results Compared with normal control group,the expressions of Sema3F mRNA,Np2 mRNA and protein in areas CA1,CA3 significantly decreased(P

ObjectiveTo explore adrenal insufficiency in the preterm infants who had critical lung diseases and the relationship between adrenal insufifciency and long-term or short-term prognosis.Methods The basal cortisol and ACTH of iffty preterm infants enrolled were tested. The peak cortisol at 30 minutes after low dose ACTH stimulation was tested. The adrenal insufifciency was deifned as the concentration of the basal cortisol less than 15 μg/dl or the increment of cortisol concentration after low dose ACTH stimulation less than 9 μg/dl. The pretern infants with adrenal insufifciency were the AI group and others were the adrenal normality, AN group.Results Thirty-one cases were adrenal insufifciency in 50 preterm infants with critical lung disease. The incidence was 62%. The concentrations of the basal and peak cortisol in AI group were lower than those in AN group (P<0.01). The increment of cortisol concentration after low dose ACTH stimulation had not signiifcant difference between two groups. The concentration of ACTH in AI group was lower than that in AN group (P<0.01). The mean arterial blood pressure in AI group was lower than that in AN group (P<0.01). The blood sugar, potassium and sodium had no signiifcant difference between two groups (P>0.05). There was no signiifcant difference in the mortality and the incidence of BPD between two groups (P>0.05).Conclusions The incidence of adrenal insufifciency was high in the preterm infants with critical lung diseases, which may be due to insufifcient production of endogenous ACTH. When the adrenal insufifciency was happened, the blood pressure is relatively low in preterm infants with critical lung diseases, but it was not related to the mortality and the incidence of BPD.

Objective:To explore whether the mRNA expression of TNFRSF12 in peripheral blood leukocytes of SLE patients is abnormal and to determine whether the TNFRSF12 gene is susceptibility gene to SLE.Methods:The level of mRNA expression of TNFRSF12 in peripheral blood leukocytes was detected by TaqMan one-step RT-PCR method.Results:The mRNA expression pattern in SLE patients is different to that of normal control.The mRNA in SLE consists of 2 types of isoforms of TNFRSF12,encoding membrane bound glycoprotein and potentially secreted molecules respectively,whereas only the latter in normal control.After PHA treatment,the mRNA expression pattern in normal control becomes the same as that of SLE patients.Overall TNFRSF12 mRNA expression was significantly decreased in active SLE group and significantly increased in lupus nephritis group.Conclusion:The results indicated that TNFRSF12 may play a role in the pathogenesis of SLE and was susceptibility gene to SLE.

Obiective To explore the dynamics of tidal breathing pulmonary function in infants with recurrent wheeze and its clinical signiifcance. Methods Eighty (80) infants with recurrent wheeze from October 2013 to February 2014 were enrolled and divided into asthma predictive index positive (n=25) and asthma predictive negative (n=55) groups, and another 20 healthy children were enrolled as control group. Tidal breath pulmonary function at the time of admission (acute phase), leaving hospital (remission phase), and a week after discharge (admission phase) were tested, the ratio of time taken to reach peak expiratory lfow to total expiratory time(TPTEF/TE)and ratio of peak expiratory volume to total expiratory volume(VPEF/VE) between groups were compared. Results From acute phase and remission phase to admission phase, TPTEF/TE, VPEF/VE were elevated in positive group and negative group showing signiifcant statistical difference between phases (P=0.000). In acute phase, TPTEF/TE, VPEF/VE showed no statistical difference (P>0.05) between positive group and negative group, when compared with control group, TPTEF/TE, VPEF/VE were signiifcantly lower in positive and negative groups than that in control group (P<0.05). In remission phase, TPTEF/TE, VPEF/VE in negative group were higher than that in positive group, but significantly lower than that in control group (P<0.05). In admission phase, TPTEF/TE and VPEF/VE in negative group and control group showed no statistical difference (P>0.05), but significantly higher than that in positive group (P<0.05). Conclusions Lung function impairment duration was longer in asthma predictive index positive children than in asthma predictive index negative children. The tidal breathing pulmonary function test can provide objective clinical indicators for infants with recurrent wheeze to predict asthma.

ObjectiveTo study the changes of iodine uptake of the follicular thyroid carcinoma cell line (FTC-133) and nude mice bearing human follicular thyroid carcinoma after the induction with alltrans retinoic acid (ATRA),trichostatin A (TSA) or ATRA combined with TSA.MethodsAfter the induction with ATRA,TSA,or ATRA combined with TSA in different concentrations for 96 h,the iodine uptake of FTC-133 cells was observed.The concentrations for different groups were as follows:ATRA 1.0 ×10-6 mol/L(Alow group),ATRA 1.0 × 10-4 mol/L(Ahigh group),TSA 1.65 ×10-7 mol/L(T group),Alow +T group,Ahigh +T group and ethanol (control group).Cell quantities and morphology were observed by HE staining.FTC-133 cells were subcutaneously injected into nude mice.Twelve nude mice were randomly divided into 4 groups after tumor formation:ATRA group (2 mg/kg,intragastric administration),TSA group (10 mg/kg,intraperitoneal injection),combined therapy group (ATRA + TSA,the same doses as above) and saline control group (10 ml/kg,intragastric and intraperitoneal administration,respectively).Drugs were administered to the tumor-bearing mice according to the mouse body mass daily.At the 22nd day,the tumor-bearing mice were injected with 37 MBq 131I intraperitoneally.The biodistribution of 131I and gamma imaging were performed at 4,6,12 and 24 h after the injection respectively.Histopathological examinations of the tumor samples were taken after imaging completion.The results were analyzed by analysis of variance (ANOVA) with SPSS 13.0.ResultsThe cellular iodine uptake were (23 885 ± 616.0 ) and ( 13 849 ±728.2) counts · min-1 · 10-6 cells in the Alow + T group and Ahigh + T group respectively,and the data were (985 ± 84.2) - ( 17 600 ± 782.7 ) counts · min-1 · 10-6 in the other groups ( F =600.879,P ＜0.001 ).The ％ ID/g of tumor at 6 h was 6.17 ±0.46 in the combined group and it increased to 9.34 ±0.61 at 12 h and 11.19 ± 0.98 at 24 h.The ％ ID/g of tumor in the other groups were from ( 1.97 ± 0.34)to (5.14 ± 0.65 ).The tumor qualities of the 4 groups were significantly different ( F =3.723,P ＜ 0.05 ).ConclusionThe iodine uptake of the tumor could be enhanced in the tumor-bearing mice administered with ATRA combined with TSA,a potential way for treating follicular thyroid carcinoma.

OBJECTIVEThe demographic characteristics of acupuncture outpatient in China is investigated so as to provide clinical evidence for the establishment of acupuncture indication.

METHODSClinical epidemiological table was adopted to do cluster multistage random sampling in 36 hospitals of 31 provinces (municipalities and autonomous regions) in 2008. The composition ratios of all indices were analyzed with SPSS 13.0 software. And trend analysis was carried out on the patient's demographic characteristics and the age distribution of clinical indications.

RESULTSIn the year 2008, 31 858 cases of out patients from 36 hospitals of 6 administrative regions were collected. There were totally 14 411 male patients (45.2%) and 17 447 (54.8%) female. The gender ratio of male and female was 82: 100. The average age of the patients was (50.6 +/- 17.7) years old. The number of patients over 45 years old was more obvious than groups of other ages (P<0.05). Age differences can be found in those 6 regions (P<0.05). Clinical symptoms varied according to different ages of the patients. Different characteristics of age distribution of acupuncture indications were held to exist (P=0.000).

CONCLUSIONAt the present, differences of gender, age and region can be found in out patients of acupuncture clinic. And the result shows that the number of female patients is more than male, with a large proportion of patients over 45 years old. Differences of age distribution characteristics of acupuncture indications still exist, which is considered to have the relation with the dominate indications of acupuncture and aging of the population.

Acupuncture Therapy ; utilization ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Demography ; Female ; Humans ; Infant ; Male ; Middle Aged ; Outpatients ; statistics & numerical data ; Young Adult

Background:Wheezing is common in early childhood and remains an important health concem.The aim of this study was to assess the lung function of wheezing infants and to investigate the relationship between lung function and respiratory outcome.Methods:Infants ＜2 years of age with acute lower respiratory tract infection (ALRTI) who had undergone lung function tests were included in the study.They were assigned to wheeze or no wheeze group based on physical examination.Infants without any respiratory diseases were enrolled as controls.Lung function was measured during the acute phase and 3 months after ALRTI.One-year follow-up for infants with ALRTI was achieved.Results:A total of 252 infants with ALRTI who had acceptable data regarding tidal breathing were included in the final analysis.Compared with the control and the no wheeze groups,infants in the wheeze group had significantly decreased time to peak tidal expiratory flow as a percentage of total expiratory time (TPTEF/TE) (20.1 ± 6.4％ vs.34.4 ± 6.2％ and 26.4 ± 8.3％,respectively,P ＜ 0.0001) and significantly increased peak tidal expiratory flow (PTEF) (90.7 ± 26.3 ml/s vs.79.3 ± 18.4 ml/s and 86.1 ± 28.0 ml/s,respectively,P ＜ 0.01),sReffand Reff.The infants in the wheeze group still had lower TPTEF/TE and volume to peak tidal expiratory flow as a percentage of total expiratory volume (VPTEF/VE) than the no wheeze infants 3 months after the ALRTI.Moreover,there was a significant inverse relationship between TPTEF/TE,VPTEF/VE,and the recurrence of wheezing and pneumonia.Conclusions:Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted.In addition,the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.

Objective Comparatively studying the method,efficiency and anti-hypoxia ability of cardiomyocytes which are directionally induced from human embryonic stem cells and mouse embryonic stem cells in vitro so as to provide an experimental basis for further study of inducing the differentiation of embryonic stem cells into cardiomyocytes in vitro.Methods Human embryonic stem cells are induced into cardiomyocytes by suspension method which dosen't using inducersand adherence method which using inducers respectively.Mouse embryonic stem cells are induced into cardiomyocytes by hanging drop method which dosent using inducers and using inducer respectively.Staining the specific marker cTnT of cardiomyocytes by immunofluorescence.Comparing the time,percentage and beating frequency of cardiomyocytes by counting under the microscope.Using apoptosis-hoechst staining kit to detect the apoptosis ratio of beating cardiomyocytes which have been treated by hypoxia with 24 h.Results The group of hESC without inducers results in that the mean time days of appearing beating cardiomyocytes is (13.9 ± 0.9) days,the percentage is 20.8 ％ and the average frequency of beating is (63.8 ± 5.6) times/min.The group of hESC with inducers results in that the mean time days of appearing beating cardiomyocytes is (13.0 ± 1.1) days,the percentage is 66.7％ and the average frequency of beating is (63.0 ± 7.0) times/min.The group of mESC without inducers results in that the mean time days of appearing beating cardiomyocytes is (14.3 ± 1.0) days,the percentage is 12.5％ and the average frequency of beating is (80.2 ± 3.9) times/min.The group of mESC with inducers results in that the mean time days of appearing beating cardiomyocytes is (12.2 ± 1.2) days,the percentage is 81.3％ and the average frequency of beating is (79.9 ±7.7) times/min.Beating cardiomyocytes of each group are positive to cTnT staining.Different apoptosis ratio are detected of beating cardiomyocytes of each group.Conclusion The four methods can all successfully induce the differentiation of embryonic stem cells into myocardiocytes,and the adherent method of hESC induced with activin A + BMP4 is the first successful induction in China.The groups adding inducers improve the differentiation efficiency more significantly than the groups without adding inducers.Inducing mouse embryonic stem cells into cardiomyocytes is more simple and efficient compared with human embryonic stem cells.Without the presence of other protective factor,anti-hypoxia ability of cardiomyocytes induced from human embryonic stem cells is stronger and the beating time are longer in vitro compared with mouse embryonic stem cells.

To obtain a most appropriate method for the evaluation of the three basic skills of clinical doctors,we designed an objective structured clinical examination(OSCE) model with standardized patients and applied it to the "three-basic" examinations among 50 doctors from various clinical departments.The results showed that this model provided a new way for the effective,objective and reliable evaluation of doctors' clinical knowledge and skills.