Mannitol is a kind of major marine bio-products with important biological activities. It is not only used in injection as raw material, but also used with other medicine as supplemental composition. Simultaneously, it is used for synthesis of a series of derivative medicines. The specific application of mannitol as raw materials and excipient was reviewed in detail. And the synthetic methods, properties and medical application of every derivative medicine were introduced.

Objective: To report a newly designed method for treating supracondylar fracture of the humerus,and to inquire into the problems of cubitus varus deformity and joint stiff.Methods:Based on a review of anatomy,a new method which called tension band with sphenoid-shaped osteotomy through posterior approach was designed and applied for 46 cases of patients in clinic.The clinical effect was compared with effect of crossing Kirchner's wire.Results:The tension band with sphenoid-shaped osteotomy was a better method and can abide by anatomical and biomechanical principles.After follow-up for 12-36 months,curative effect was estimated as follow:30 cases were excellent,14 cases good and 2 cases poor according to Home's evaluation.Conclusions:It is a better methods in treating supracondylar fracture of the humerus following advantages including simple,reliable fixation and early mobilization etc.

Objective To establish an objective animal experimental model for the experimental study of clinical bone defect,detect the BMP-2 activity in bone defect area,and observe the early healing situation of rabbit radial fracture.Methods A total of 72 New Zealand rabbits [weight/ each:(2.8 ±0.2)kg] were randomly divided into four experimental groups A,B,C,and D (18/each) with corresponding 0.5 cm,1.5 cm,2.0 cm,and 3.0 cm bone defect models abolished,respectively,in the middle of the rabbit left radius.By the time of modeling,all the bone segments were retained and a small amount of bone adjacent tissues were taken as E specimens of control group.Modeling time was recorded as 0 week,and six animals of each group were killed in 1 W,3 W,4 W later.Then the bone defect surrounding tissues were taken to check BMP-2 content by Western-blot detection,and the bone-healing situation was observed at different time.Results BMP-2 composition showed a significant increase in secretory volume of each group's bone defect area tissues after modeling one week,compared with E specimens of control group (P ＜ 0.05).BMP-2 composition secretion capacity even reached its peak in the third week four groups (A,B,C,D)increased by 556.1％,385.9％,272.2％,171.2％ respectively.and BMP-2 content reduced apparently in the fourth week than before(P ＜ 0.05).At the same time,BMP-2 content decreased with the addition of bone defect length(P ＜ 0.05).Also a correlation was shown between bone healing and time with the bone defect length.Conclusions A comparable rabbit radial bone defect model was successfully established.These objective animal models,which are closer to clinical reality,provide the theoretical basis of animal experiments to explore the mechanism of human fracture healing.

Thyroid hormones play major roles in the regulation of a wide range of metabolie and physiologic processes.Serum thyroid-stimulating hormone( TSH ) concentration,a sensitive barometer of thyroid function,shows significant individual difference in which genetic variation is a major factor.After using traditional genetic linkage studies and candidate gene association studies to explore the suseeptibility genes of serum TSH,many progresses have been made and new susceptibility genes have been identified by genome-wide association study (GWAS).In this review,we focus on the susceptibility genes of serum TSH levels and also the future prospect that may be obtained from these studies.

The emerging technologies change rapidly in the medical field, refresh the medical ethical scenari-os, brought some medical ethical blind spot.Therefore, building the platform of academic research, making use of the new media, MOOC and“flipped classroom”, inheriting the native“The Spirits of A Great Physician” in tradi-tional Chinese medicine and western medicine, life ethics education and sublation of new exploration, the ideolog-ical and moral education for medical students is expected to be improved in China.

Objective To assess the efficacy and safety of emergency transcatheter arterial embolization in the management of intractable postpartum hemorrhage. Methods Twenty-five patients with intractable postpartum hemorrhage were undertaken superselective catheterization into the bilateral internal iliac arteries or uterial arteries to find the causes and sites of bleeding through DSA and then followed by arterial embolization with gelfoam particles. Result All of the 25 patients with obstetrical bleeding were successfully controlled by TAE, the procedure lasted for 25 - 60 min, (mean 42.5 ? 4.6 min); with both catheterization and bleeding halt successful rates of 100%. Comparison of hemoglobin and heartbeat before and after the procedure showed significance(t = 29.49, P

Objective To investigate the surgical indicatin and outcome of recurrent gastric carcinoma.Methods Review the clinical data of 56 cases with recurrent gastric carcinoma underwent reoperation from 1990 to 2000.The operative indication, surgical method and complications were analized.Results In 25 cases the recurrent tumor were resected (44.6%),in 10 cases adjacent organs were resected.NO operative motality was observed.Conclusions More aggressive radical resection of the gastric cancer is the key to prevent recurrence.Laparotomy should be performed without delay once there is a suspicion of recurrence.

Objective To investigate the value of elasticity score and elasticity strain ratio (SR) in predicting the central lymph nodes metastasis of papillary thyroid microcarcinoma (PTMC). Methods This study conducted a retrospective analysis of ultrasonography ifndings of 236 thyroid lesions from 208 patients. All of them underwent surgery in Ruijin Hospital of Shanghai Jiao Tong University from June 2012 to March 2013. Totally 82 PTMC from 82 patients were included in this study. Among them 12 patients with 12 PTMC had central lymph nodes metastasis. The elasticity score and SR were compared between metastasis and non-metastasis groups, and the receiver operating characteristic (ROC) curve of SR was calculated. Results The differences of PTMC elasticity score between two groups showed no statistical signiifcance (χ2=5.00, P=0.08). The average SR of the group with central lymph nodes metastasis is 2.44±0.61, which is higher than the group without lymph nodes metastasis whose average SR is 1.67±0.42. Differences are statistically signiifcant (t=5.5, P=0.00). The area under curve of SR-ROC curve was 0.847. Using 2.01 as cutoff of SR, the sensitivity, speciifcity, accuracy of predicting central lymph nodes metastasis was 83.3%, 81.4%, 78.6%respectively. Conclusion The SR but not elasticity score could be a meaningful indicator for predicting lymph nodes metastasis.

Aim To investigate the effect of TRPV4 on hepatic fibrosis of rats . Methods Liver fibrosis model of rats was induced by 50% CCl4 twice a week for 12 weeks. HE and Masson staining were used to evaluate the degree of hepatic fibrosis, and the levels of α-smooth muscle actin(α-SMA) and TRPV4 were detec-ted in fibrotic liver tissue by Western blot. HSC-T6 cells were activated by transforming growth factor β1 (TGF-β1),and the protein levels of α-SMA, TRPV4 were detected by Western blot. After using Ru and transfected with TRPV4-siRNA, HSC-T6 was stimula-ted with TGF-β1, the levels of α-SMA, TRPV4 and phosphorylation level of Akt were determined by West-ern blot. Results TRPV4 was highly expressed in model liver tissues and in activated HSC-T6 induced by TGF-β1 . The levels of α-SMA and phosphorylation of Akt decreased in TGF-β1-induced HSC, used with Ru or transfected with TRPV4-siRNA. Conclusions The expression of TRPV4 increases in fibrotic livers and ac-tivated hepatic stellate cells. Knockdown of TRPV4 can suppress the activation of hepatic stellate cells in-duced by TGF-β1 , and decrease the phosphorylation levels of Akt.

OBJECTIVE:To explore the effects of umbilical therapy by Rheum plamatum combined with early colonic irriga-tion on the quality of life in elderly patients with colon stoma. METHODS:80 patients underwent radical resection of abdominoperi-neal rectal carcinoma were randomly divided into control group and observation,with 40 cases in each group. Control group was given early colonic irrigation;observation group was additionally given umbilical therapy by R. plamatum. Treatment course of 2 groups lasted for one month,and both were followed up for 6 months after treatment. The quality by life in 2 groups was evaluated by using QLQ-C30,and therapy costs were calculated before and after treatment. RESULTS:Compared with before treatment, function score and total health score of 2 groups improved significantly in 1,3,6 months after treatment,while symptom score and single item score decreased significantly,with statistical significance(P<0.05). In 1,3,6 months after treatment,role func-tion,social function,cognitive function,emotional function and total health score of observation group were significantly higher than those of control group,and insomnia and pain score were significantly lower than control group,with statistical significance (P<0.05). 3 and 6 months after treatment,diarrhea and economic difficulty score of observation group were significantly lower than those of control group,with statistical significance(P<0.05). 1 months after treatment,loss of appetite score of observation group were significantly lower than those of control group,with statistical significance (P<0.05). 6 months after treatment, fa-tigue,nausea and vomiting score of observation group were significantly lower than those of control group,with statistical signifi-cance (P<0.05). 6 months after treatment,nursing cost,drug cost and total cost of observation group were significantly lower than those of control group,with statistical significance(P<0.05). CONCLUSIONS:The umbilical therapy by R. plamatum com-bined with early colonic irrigation can improve the quality of life in elderly patients with colon stoma significantly and reduce treat-ment cost.