0.05).Complications included 6 cases of delayed union,1 cases of severe elbow stiffness,3 cases of heterotopic ossification,2 cases of ulnar nerve palsy,in which one case recovered after 6 months,another case remained symptoms.[Conclusion]With appropriate training aids,the majority of patients have good effect.Same good clinical outcome have been achieved for treatment of intracondylar humeral fractures with either triceps splitting approach or the olecranon osteotomy approach.

This paper gives the brief account of the researches in the effection of the side- cuts in perineum carried out in two angles (45°and 25～30°) during the helps in child birth between two groups of eutosia on the similar condition:fetal weight the contradict of womb perineum tissue e. g.. The results show that amnong 116 parturients with side- cut in 45( contrated group), the rate of tearing is 62.06%; on the contrary, among 110 parturients with side - cut in 25 ～ 30°( improved group), the rate of tearing is 35.45 %. According to statistics analysis, the rate of tearing in two groups has a marked difference (P＜0.01). It directly shows the parturients in improved group have the advantages:shortening the sewing- up time lessening needling numbers reliving of the after - pains making the parturients get out bed some time later and sulkle the new- born babies in sitting way,reducing the nursing,shortening the time of infection.

Objective To discuss the clinical treatment of unstable dislocation of the sternoclavicular joint with clavicle hook plates. Methods From April 2005 to October 2007, 19 cases of unstable dislo-cation of stemoclavicular joint were treated with open reduction and internal fixation by clavicle hook plates. There were 17 cases of Grade type Ⅲ and 2 cases of Grade type Ⅱ. After open reduction and internal fixation, all patients received arthroplasty and repair of eostoclavicular and sternoclavicular ligaments. Results None had intraoperative injury to nerves and blood vessels. Follow-ups from 6 to 24 (mean, 8) months showed 16 excellent cases, 2 good cases and 1 fair case by Roekwood criteria, the good to excellent rate being 94.7%. The healing duration lasted 3 to 6 (averaging 4) weeks. No infection, sliding or loosening of internal fixation, nonunion or re-dislocation was found postoperatively. Conclusion The clavicle hook plate is an effective and advanced surgical treatment of sternoclavieular joint injuries, because its easy and mini-invasive operation can provide sturdy fixation and lead to good functional recovery.

Objective To evaluate the image quality and obtained by the tube current modulation base on time bolus peak in low voltage in CTPA.Methods 30 consecutive patients suspected pulmonary embolism(PE)were prospectively enrolled,and satisfy the following conditions.The study was performed by 64-slice spiral CT system (lightspeed VCT-XT,GE healthcare),Tube voltage was set at 80 kV.Tube current settings related to the attenuation of ROIs by test bolus peak.The injection parameters were set up by injection flow rate (4 mL/s),contrast medium dose (28 mL),and saline flushing dose (40 mL).All images were evaluated by two observers blinded to pulmonary CTA protocol,including attenuation,noise,SNR and CNR.The image quality was evaluate by 4-score.To evaluate the relationship between influential factor and image quality using Pearson correlation analysis.A P-value <0.05 was considered to indicate a statistically significant difference.Results The time bolus peak was statistically significant influence on attenuation(r=0.398,P =0.029).There was no statistically significant influence on noise (r=0.104,P =0.583),signal-to-noise ra-tio (r=0.263,P =0.1 60)and contrast-to-noise ratio(r=0.299,P =0.109).The other factors(BM,BMI and BSA)was no statisti-cally significant influence on the image quality(P > 0.05 ).The mean attenuation,noise,SNR and CNR on pulmonary trunk was (628.63±146.46)HU,(53.92±14.07)HU,12.02±3.1 7 and 10.81±3.10,respectively.The percentage of assessable pulmonary arteries was 95.82%.Conclusion The tube current modulation base on time bolus peak in low voltage could offer assessable image quality and raise image stability.

Objective To observe the expression of SGK in decidua in patients with unexplained recurrent spontaneous abortion(URSA) and to investigate its role in the course of apoptosis.Methods The expression of SGK was detected by immunohistochemistry in decidua of URSA(abortion group,n =50) and normal first trimester pregnant women(control group,n =30).The apoptotic index was detected by TUNEL.Results Compared with the control group,the positive expression of SGK decreased significantly in the abortion group,and the difference was statistically significant(x2 =6.78,P ＜ 0.05).The average apoptotic index of the abortion group was (8.19 ± 3.58) ％,which was significantly higher than (2.87 ±1.07)％ of the control group(t =7.94,P＜0.05).Conclusion Intensive apoptosis,the decreasing positive expression rate of SGK in decidua cells may play critical roles in URSA.

Objective To evaluate indwelling intrapulmonary artery catheter thromolysis for acute pulmonary embolism.Methods From June 2011 to June 2013 56 cases of acute pulmonary embolism were diagnosed by multi-row spiral CT and admitted at the Department of Vascular Surgery.The average age was (56 ± 11) years.Inferior vena cava filter was implanted and pulmonary angiography,catheter thrombectomy,indwelling pulmonary intraarterial thrombolytic therapy was performed.Postoperatively low molecular weight heparin and warfarin was given,dosage adjusted by prothrombin international normalized ratio at 2-3.Results Mean pulmonary arterial pressure (mPAP) decreased from (43 ± 7) mmHg to (22 ± 6) mmHg (P ＜ 0.05),arterial partial pressure of oxygen (PO2) rose from (49 ± 8) mmHg to (83 ± 9) mmHg (P ＜ 0.05).Clinical symptoms significantly relieved in 51 out of the 56 cases (91％).45 patients were followed up for an average of (15 ± 4) months,with one recurrence.There was no filter migration,vena cava thrombosis,chronic obstructive pulmonary disease and other complications.Conclusions Emergency pulmonary artery indwelling catheter thrombolysis is safe and effective therapy for acute pulmonary thromboembolism.

Angiofibroma ; Angiomyoma ; Ear Auricle ; blood supply ; Ear Neoplasms ; Humans ; Male ; Middle Aged

Objective To investigate the effect of Kangaroo care(KC)on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups:intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC(neonates were put in direct and continuous skin-to-skin contact with his/her mom)from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN(Douleur Aigue Nouveaune)scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect(P<0.01),which showed that the heart rate of two groups were not equal at different time points.Compared with the time effects(P<0.01)which showed that two groups of neonatal heart rate of the two groups would accelerate with time extension. There were significant differences(all P<0.05)in heart rate at 7 time points between two groups and smaller heart rate varied range in intervention group.The results of repeated measures analysis for neonatal blood oxygen saturation at 7 time points after heel lancing. There were significant interaction effect between time and main effects(P<0.01),which showed that the blood oxygen saturation of two groups were not equal at different time points.Compared with the time effect(P<0.01),which showed that two groups of neonatal blood oxygen saturation would reduce with time extension.There were significant differences(all P<0.05)in blood oxygen saturation of two groups at 30s,40s and 50s after heel lancing and smaller blood oxygen saturation varied range in intervention group.The crying duration and DAN scores in intervention group were significantly reduced compared with the controls(all P<0.05).Conclusions
Heel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.

Alzhelmer's disease (AD) is an important neurodegenerative disease. Recent evidence has indicated that the production and loss of the myelin,sheath are associated with AD because the particular vulnerability of oligodendrocytes produced in the late stage makes the loss of the myelin sheath take a core position in the changes of the earliest stage of AD. The loss of the myelin sheath disrupts synchronization of impulses on which normal brain functions highly depend, and ultimately results in the function disruption of cortical association regions and subsequent neuronal loss. Meanwfiile, there are diverse mechanisms that make oligodendrocytes degeneration exist in the brains of AD. Therefore, elucidating its specific mechanism may help better understanding of AD, and thus provide some help for its treatment.

Objective To evaluate the relationship between smoking and p53 gene mutation in the lung cancer patients with Meta-analysis.Methods PubMed,Web of Science,ProQest and Medline were used to search all the relevant studies about the association between smoking and p53 gene mutation in the patients with lung cancer. Based on reviewing full text,the studies were selected and evaluated and the data was extracted.Statistical analysis was performed with Stata 1 2.0 software including the heterogeneity inspection, publication bias assessment, sensitivity analysis,effect consolidating and cumulative Meta-analysis.Results Totally 15 articles with 1 770 lung cancer patients were identified. 69.6% of the patients were smokers,30.4% were non-smokers.Overall,the smokers with lung cancer had a 2.70-fold higher risk for p53 gene mutation than the non-smokers with lung cancer (OR=2.70,95%CI=2.04-3.59).Conclusion p53 gene mutation is associated with smoking in the patients with lung cancer.The smokers with lung cancer have higher risk for p53 mutation than non-smokers.