To investigate the mechanism of lead biosorption and biotransformation in lead-resistant bacteria in microcosmic scale, synchrotron radiation micro X-ray fluorescence (μ-SRXRF ) and X-ray absorption near edge structure ( XANES) was used to determine the element distribution characteristics and speciation of lead ( Pb) in lead-resistant bacteria strain isolated from farmland soil samples taken from a lead-zinc mine in Lanping county, Yunnan province in China. The isolated species was identified to be Arthrobacter sp. The concentration of Pb biosorpted in lead-resistant bacteria was directly determined byμ-SRXRF, and the results showed that the highest concentration was 5925μg/g and the bioaccumulate factor was 14 . 8 . Speciation of Pb in lead-resistant bacteria B2, LB ( Lysogeny Broth) medium and soil were also presented after using Pb LⅢXANES. Compared with Pb LⅢ XANES peak shape and peak position between standard samples, it was demonstrated that the Pb in lead-resistant bacteria was mainly formed by amorphous forms like PbS (58. 0%), (C17H35COO)2Pb (22. 2%), Pb5(PO4)3Cl (19. 8%) rather than organic Pb speciation which was exist in LB medium. Therefore, the isolated lead-resistant bacteria could biotransform Pb to sulfuric compounds. The biotransformation regular could be of great interest for other investigators as reference in study of bioavailability impact factor of heavy metals.

Objective To discuss how to improve the cultivation level of postgraduates majored in general surgery by special training.Methods We retrospectively analysed the work performance of 78 postgraduates in the first year after graduated from the general surgery of our hospital during 2005 to 2009. The employer’s evaluation of the postgraduates was compared between before and after special training.Results 22 postgraduates didn’ t receive special training,and 56 postgraduates receive special training. The clinical skills and clinical thinking ability of the postgraduates received special training were much better than the postgraduates who didn’ t receive special training, there was a significant difference between two groups ( P<0.05 ) . Conclusion The special training can significantly improve the clinical skills and clinical thinking ability of the postgraduates majored in general surgery in our hospital.

Proximal tibial fractures, especially high energy ones, can incur unique challenges in clinical treatment. Soft tissue is injured from both fracture and surgical dissection; the fracture often brings with it neurovascular problems; it is difficult to reduce and stabilize proximal fragments. Treatment strategies of dealing with associated injuries, accurate diagnosis, and selection of individualized method for reduction and fixation are emphasized. Soft tissue protection should always be kept in mind during operation.

Complex Pilon fracture is always a challenge to orthopaedic surgeons. Careful assessment of the injury, especially the soft tissue condition, is essential for a proper treatment planning. Classification of the fracture is also important for evaluation of the prognosis. Treatment planning includes: timing of the surgery, selection of the fixation method and postoperative protocols. In this article, on the basis of literature review and personal experience, the author suggests criteria for injury assessment and postoperative treatment. A brief comparison of different kinds of fixation is made and the principle of implant selection is discussed in the text.

Objective:To propose the requirement of hospital development quality inspection information management system, develop solution, avoid cost enormous waste problem and realize the system on-line.Methods: Use the UML method to develop hospital equipment management information system, and completed a detailed description of its specific use case diagram, sequence diagram, class diagram.Results: Equipment operation rate increased by 10%, significantly shorten specimens control time of, the fault response time decreased from 10min to 1 min, quality control indexes increased to 16%.Conclusion: The UML-based LIS system improved the work efficiency of the equipment, received the satisfactory effect.

Objective To investigate the effect and molecular mechanism of Andrographolide (AD) on matrix metalloproteinase-9 (MMP-9) expression in human colon cancer H 3255 cells. Methods Human lung cancer H3255 cell line weve cultured in vitro, and treated with 1.0, 3.0, 5.0μmol/L AD for 24 h, untreated cells was used as blank control. Cell viability, cell migration and cell invasion were analyzed by MTT assay, scratch healing assay and transwell membrane assay, respectably. Expression of MMP-9 mRNA was analyzed by RT-PCR. Protein expression and phosphorylation of Akt were detected by Western blot. Activity of NF-κB and MMP-9 were analyzed by luciferase reporter assay. Results AD could significantly reduced H 3255 cells invasion and migration without affecting the viability of cells, as demonstrated by scratch healing and transwell membrane assay. Furthermore, Western blot and RT-PCR results showed that AD could markedly inhibited MMP-9 activity and its expression in both protein and mRNA levels. AD could attenuated Akt’s phosphorylation and the activity of NF-κB. Moreover, LY 294002, an inhibitor of PI3 K, could significantly inhibited NF-κB transcriptional activity and MMP-9 expression. In addition, different concentrations of AD could inhibit the promote activity of MMP-9. Conclusion AD was a potential anti-invasive agent by inhibiting MMP-9 involved in PI3 K/NF-κB pathways.

Objective To discuss the value of preoperative C-reactive protein (CRP) and eryth-rocyte sedimentation rate (ESR) in predicting postoperative infections following multiple fractures. Methods A study was conducted in 78 patients with multiple fractures (complicated with pelvic frac-ture, ISS > 18) treated in our department from December 2006 to March 2009. CRP and ESR levels be-fore second damage control operation as well as postoperative infections were recorded. Meanwhile, the optimal cut-off value was determined by receiver operating characteristic curve and analyzed. Results There were 11 patients with postoperative infection. The preoperative optimal cut-off value of CRP was 50 mg/L, with a sensitivity of 0.909 and a specificity of 0.821. The preoperative optimal cut-off value of ESR was 27.5 mm/h, with a sensitivity of 0.818 and a specificity of 0.791. The combination tests showed the sensitivity and specificity of 0.875 and 0.900 respectively. Conclusion CRP (50 mg/L) can be a sensitive predictive index for postoperative infection in the multiple fractures (complicated with pelvic fractures). Combination test of CRP and ESR can benefit diagnosis of postoperative infection.

Objective To analyze the validity and safety of using a novel posteromedial approach whose L-shaped incision is reversed in treatment of posterior fractures of the tibial plateau. Methotis Anatomical research was performed on 4 fresh-frozen cadaveric specimens with 8 normal knees. All specimens were dissected by the posteromedial reversed L-shaped approach. Parameters of the important structures were measured. Results two important structures were involved in the novel approach. Including medial saral artery and vein and inferior medial genicular artery. The average distance between the eruptive site of medial sural artery and articular surface was 45.29 mm, and the average length ofmedial sural artery was 36.28 mm. The average distance between the eruptive site of inferior medial genicular artery and articular surface was 10.12 mm. The main posterior structures of the proximal tibia were all surveyed by the single approach, including the posterior bi-condyles and the tibial insertion of the posterior crueiate ligament. Conclusion The posteromedial reversed L-shaped approach is an effective approach for treating posterior fractures of the tibial plateau or posterior injuries of the proximal tibia, because it is less invasive, highly safe, simple in anatomy, direct and sufficient in exposure.

Objective To compare the effects of dexmedetomidine on the respiration and circulation with midazolam in mechanically ventilated patients.Methods A total of 62 patients supported with mechanical ventilation in medical intensive care unit were randomly (random number) divided into two groups:midazolam group ( group A,n =38 ) and dexmedetomidine group ( B group,n =24).The patients in group A were intravenously administered with midazolam in bolus dose of 0.05 mg/kg given over 30 - 60 s,and then maintained with 0.05 -0.15 mg/(kg ·h) by venous pump.The patients in group B were intravenously administered dexmedetomidine in bolus dose of 1.0 μg/kg given in more than 10 min,and then maintained with 0.2 - 0.7 μg/( kg · h) by venous pump.When the patients' sedation degree were required to reach Ⅲ - Ⅳ Ramsay Grade,the heart rate,mean arterial pressure,respiratory rate and SpO2 before sedation were compared with those 10 min,30 min and 2 hours after sedation between two groups.Results Respiratory rate or heart rate after sedation significantly decreased compared with those of presedation ( P ＜ 0.05 ).Blood pressure after sedation did not decrease significantly compared with that of presedation in Dexmedetomidine group.In midazolam group,blood pressure was (83.11 ± 12.95 ) mm Hg before sedation,and there was a significant decrease to (74.13 + 12.50) mm Hg in 10 min after sedation (P ＜ 0.05 ),while there were no significant difference between ( 80.53 + 12.93 ) mm Hg 30 min after sedaton and (82.47 ± 12. 15 ) mm Hg 2 hours after sedation.Conclusions There is no difference in effects on respiration of mechanically ventilated patients between dexmedetomidine and midazolam,and the effect of dexmedetomidine on circulation was less than that of midazolam.

Objective To observe the effect of Aquacel AG dressing in treating diabetic foot and nursing measures.Methods Seventy-nine hospitalized patients diagnosed as diabetic foot were enrolled,and 45 of them were chosen randomly as the experimental group,who was treated with Aquacel AG dressing,and changed the dressing per 3 to 5 days.The other 34 patients were named as the control group,who was treated with normal cotton dressing by wet compress,and changed the dressing one time per day.The total effective rate and healing condition were compared between the two groups.Results The total effective rate of the experimental group was 93.3％,higher than that of the control group (79.4％) significantly.The healing time of the experimental group was (64±10)days,shorter than that of the control group,(88±12)days.Conclusions Aquacel AG dressing was suggested to use in treating diabetic foot.