Objective To compare and analyze the clinical effects and reliabilities of intermandibular flexible distraction and rigid internal fixation in treating mandibular condylar fractures. Methods Of 40 patients with mandibular condylar fractures, 21 cases were managed with intermandibular flexible distraction (external fixation group, Group A) and 19 with rigid titanium internal fixation (internal fixation group, Group B). There were 15 cases with high position fractures and 25 with low position ones. Results During 2-4 weeks postoperatively, X-rays confirmed the condylar fracture healing in all cases with no loosened mini-tinum plates in the Group B. There were 10 cases in the Group A and 14 cases in the Group B with the opening width over 30 mm, and 11 cases in the Group A and 5 in the Group B with the opening width less than 30 mm. Conclusions Both external and internal fixations can attain condylar fracture healing. However, compared with the internal fixation, the reduction of external fixation is less exact and the function recovery slower after operation, especially in the low position fractures. No irreversible damages on TMJ happen in all cases.

BACKGROUND:Distal femur is a predilection site for primary bone tumors, most of which are treated with salvage treatment. There are many reports on the early-stage, mid-term and prognosis of the distal femur tumor-type artificial knee joint prosthesis, but reports on long-term function and prognosis are less.
OBJECTIVE:To study the long-term prognosis and limb function after treatment with rotating-hinge knee prosthesis.
METHODS:Thirty-four patients with distal femoral bone tumors admitted to the Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University between January 2000 and June 2008 were retrospectively analyzed, including 19 males and 15 females. Al patients were subjected to rotating hinge knee prosthesis replacement.
RESULTS AND CONCLUSION:The mean fol ow-up period was 62.4 months (range 11 to 126 months). At the final of fol ow-up, 23 patients were event-free alive and 11 patients were dead. Seven of 23 survival patients suffered from prosthesis related complications, including four cases of prosthesis revision and three cases of amputation. The event-free survival rate of 23 patients undergoing replacement of domestic tumor prosthesis around the knee was 67.6%in 5 years. The mean functional score of affected limb was 19.30 (7 to 27 points):excellent in 6 cases, good in 16, fine in 5 and poor in 2. The excellent-good rate was 75.9%. The clinical outcomes suggested that the satisfactory limb function and survival rate could be achieved with the application of domestic tumor prosthesis replacement for treatment of malignant bone tumors around the knee.

Objective To investigate the prevention and mechanism of Extracorporeal shock wave lithotripsy(ESW) induced renal Injury by pre-treating kidneys with low-energy shock waves(LESW).Methods Forty healthy female domestic rabbits were surgically managed to the mono-nephron models and random divided into 4 groups consisting of ten each: Control,LESW,ESW and ESWL plus LESW pretreated groups.LESW group received 100 LESW,ESW group received 1500 standard ESW,and same dose on ESW group except 100 LESW pretreatment in ESW plus LESW pretreated group.The rabbit kidney tissues were obtained 24 hours after ESW.Activity of superoxide dismutase(SOD) and malondialdehyde(MDA) levels in the renal tissue,and the level of N-acetyl-β-D-glucosaminidase(NAG) in urinary were measured.Renal cell apoptosis was detected by TdT-mediated dUTP Nick End Labelling(TUNEL).Results The MDA,the urinary level of NAG and rate of apoptosis in the LESW groups were reduced(P<0.01),and the activity of SOD increased significantly(P<0.05) as compared with ESW group,and these changes in LESW group had no statistics difference compared with the control group(P>0.05).Conclusions LESW pretreatment protocol substantially limits the renal injury that often caused by ESW.LESW may suppress oxidative stress and antagonize the process of renal cellular apoptosis.

Objective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.

Objective To evaluate the curative effects and safty of contra-aperture dissection and skin bridge preservation in the treatment of low transphincteric perianal fistula.Methods Sixty subjects of low transphincteric perianal fistula were randomly divided into two groups.Thirty cases of treatment group were treated by contra-aperture dissection and skin bridge preservation,and 30 cases of control group were treated by anal fistulectomy.On the second,seventh and fourteenth day after operation,the postoperative pain,exudate and fever were recorded and scored.The curative time was observed.Anorectal dynamic changes were compared simultaneously to evaluate the curative effects and safety of contra-aperture dissection and skin bridge preservation.Results The scores of pain and exudate were significantly different between the treatment and the control group(P＜0.01).The wound-healing time was shorter in the treatment group than that in the control group((27.37±8.93) d vs.(32.73±9.45) d,P=0.000).There were significant differences in the anal resting pressure,anal maximal contraction pressure and active systolic pressure between the two groups (t =13.12,10.21,12.10;P＜0.01).There was no significant difference of total effect between the two groups(100％ and 93.3％;x2 =2.07,P＞0.05).Conclusion Contra-aperture dissection and skin bridge preservation can reduce postoperative pain,exudate and fever,shorten wound-healing time and protect anal functions in the treatment of low transphincteric perianal fistula.

Background5-Nitro-2-(3-styrene-acrylic amine) benzoic acid ( NPPB),a chloride channel inhibitor,has a promoting effect on cell apoptosis in myocardial ischemia and reperfusion of domestic rabbit.The CIC chloride channel has been found in the ocular trabecular cells.However,the effect of NPPB on the shape and function of trabecular cells is unclear. Objective This study was performed to investigate the effect of NPPB on the proliferation,cell cycle progression and apoptosis of human trabecular meshwork cells.MethodsThe immortalized human trabcular cell strain was cultured,and logarithmic-phase cells were incubated in 96-well plates at a density of 1 ×106/ml.Different concentrations of NPPB (10,50,100 μ mol/L) were added to the medium,and the MTT assay was used to assess the growth and proliferation of the cells.Flow cytometry was used to evaluate the cell cycle.Then,100 mg/L 5-FU or 100 mg/L 5-FU + 100 μmol/L NPPB was used to induce cell apoptosis,which was assessed by Annexin V-PI.The membrane potential of mitochondria was examined using rhodamine 123 (△ψm).Results After 48 hours of treatment with NPPB,the abosorbency (A value) of the cells was gradually lowered with the increasing dose of NPPB,with significant differences among the 4 groups (F =7.230,P =0.006).Compared with the 10 μmol/L NPPB group,the A values were significantly declined in the 50 and 100 μmol/L NPPB groups (t =1.610,P =0.025 ;t =12.270,P =0.001 ).Forty-eight hours after exposure to NPPB,the percentage of cells in G0/G1 phase was increased and that in the S phase was decreased.The percentages of cells in different phases of cell cycle were significantly different in comparison with their control groups (without NPPB)( P＜0.05 ).Twenty-four and 48 hours after the treatment with 100 mg/L 5-FU,the apoptosis rates of the cells were raised in the 100 mg/L 5-FU group and 100 mg/L 5-FU + 100 μmol/L NPPB group compared to the without NPPB group (t24h =2.130,P =0.023;t48h =4.810,P=0.011 ) ;while that in the 100 mg/L 5-FU+100 μmol/L NPPB group was higher than the 100 mg/L 5-FU group ( t24 h =1.980,P =0.037 ; t48 h =1.290,P =0.028 ),and the mitochondrial membrane potential was lowered ( t24h =1.580,P =0.029 ; F48 h =6.200,P =0.015 ).Conclusions NPPB suppresses the proliferation of human trabecular cells and promotes the cells to enter S phase via the G1/S check point.In addition,ClC might be involved in an anti-apoptosis mechanism through the internal mitochondrial pathway.

The possibility that a recombinant protein vaccine based on xenogeneic homologous FGFR-1 of chicken induces production of autoantibodies against self-FGFR-1 in BALB/c mice was examined by using ELISA, Western blot analysis and ELISPOT assay respectively. Autoantibodies against mouse FGFR-1 were identified by Western blot analysis and ELISA. Compared with the two control groups, the number of APBCs, which were detected by ELISPOT assay, was significantly increased in the spleens of mice immunized with cFR1 (P < 0.05). IgG1 and IgG2b, which were detected by ELISA, were the major subclasses and were substantially increased in response to chicken FGFR-1 when compared with control group. The recombinant chicken FGFR-1 protein used as a vaccine can induce autoantibodies against self-FGFR-1 in mice and provide a basis for the active immunotherapy of tumor angiogenesis.

The M and NP genes of H5N1 avian influenza virus (A/chicken/Hubei/489/2004) were amplified by RT-PCR from viral RNA,and cloned into pMD 18-T vector respectively.The expression plasmid containing the M gene (pHM6-m) or the NP gene (pHM6-np) was then constructed by inserting the M or NP gene into the pHM6 eukaryote expression vector; the constructed plasmid was then sequenced.32 BALB/c mice (6-week-old) were divided into four groups at random.Three groups of BALB/c mice were inoculated one time the intramuscular route with either 30 μg of plasmid pHM6-m,30 μg of plasmid pHM6-np or the mixture of plasmid pHM6-m (15 μg ) and pHM6-np(15 μg) respectively.A additional group of mice were injected with 100 μ1 PBS as controls.Two weeks later,all mice were challenged with homologous H5N1 avian influenza virus,and observed in the following 12 days.The survival rates of mice in the pHM6-m group,the pHM6-np group and mixed plasmids group were 62.5% ,25.0% and 50.0%,respectively.Results showed that effective protection could be provided by either pHM6-m or pHM6-np,but pHM6-m provided a better protective effect than pHM6-np.

Objective To explore the demands of nursing staff on nursing repository and provide reference for the develop-ment of nursing repository. Methods In-depth interview was conducted on 21 nursing staff by qualitative research. The themes were formed by category analysis. Results There were four themes about the demands of nursing staff on nursing repository:necessity to develop nursing repository ,contents of the repository ,forms of the repository and prospect of the reposi-tory. Conclusions Nursing staff need a nursing repository. They hope that the repository can provide comprehensive,concrete and practical knowledge,and provide a good interface with digitization. The design of repository should be consistent with in-ternational standards.

Objective To investigate the efficacy of gastric bypass surgery for the treatment of nonobese type 2 diabetes mellitus. Methods From November 2008 to August 2009, 40 patients with gastric diseases and nonobese type 2 diabetes mellitus were admitted to the Changhai Hospital, and their clinical data were prospectively studied. All patients were randomly divided into 4 groups; 10 patients received Billroth I distal gastrectomy +gastroduodenal anastomosis (BⅠ group) , 10 received proximal gastrectomy + remanant gastric esophageal anastomosis ( PG group), 10 received total gastrectomy + esophagoduodenal Y-anastomosis ( RY group) and 10received subtotal gastrectomy Billroth Ⅱ gastro-jejunostomy (BⅡ group). The length of hospital stay, pre- and postoperative body mass indexes (BMIs) , waist circumferences, levels of fasting blood glucose (FBG) , glycated hemoglobin ( GHbA1) , fasting serum insulin (FSI) and fasting C-peptide (FCP) of patients in the 4 groups were compared. All data were analyzed using analysis of variance, LSD-t test, paired t test or chi-square test. Results The clinical effects of the 4 different operative procedures on the gastric diseases were similar. The levels of FBG were (8.0 ±2.9)mmol/L before operation and (5.9 ±0.7)mmol/L after operation in the RY group, with a significant difference (t = 2. 342, P < 0. 05). The preoperative level of GHbA1 in the RY group was 7.7% ± 1.1%, which was significantly higher than 6. 9% ± 0. 6% at 2 months after the operation and 6. 1 % ± 0. 4% at 6 months after the operation (t = 4. 920, 3.012, P < 0.05). The preoperative level of FCP in the RY group was (1.30 ±0.54) μg/L, which was significantly lower than (1.95 ± 0.86) μg/L at 2 months after the operation and (2.18 ± 0.63)μg/L at 6 months after the operation (t =6. 063, 4. 651, P < 0.05). The levels of FSI in the RY group at postoperative month 1, 2 and 6 were (18 ±5) , (19 ±3) , (21 ±3) mU/L, which were significantly higher than the level of FSI [(11 ±4) mU/L]before operation (t =3. 158, 4. 502, 7. 517, P <0. 05). Preoperative levels of FBG, GHbA1, FSI and FCP in the B Ⅱ group were (8. 3 ± 1. 3) mmol/L, 7. 7% ±0. 9% , (13±4)mU/L and (1.34±0.48) μg/L, which were ignificantly different from (6.7 ± 1.2)mmol/L, 6.8%± 0.8%, (18±4)mU/L and ( 1.68 ±0.46) μg/L at postoperative month 1, (6.4 ± 1.3)mmol/L, 6.3% ±0.6% ,(18±4)mU/L and (1. 96 ± 0. 67) μg/L at postoperative month 2, and (5. 6 ±0. 7) mmol/L, 6.0%±0.3%, (19 ± 4) mU/L and (2.27 ± 0. 59) |μg/L at postoperative month 6 (t = 2. 468, 2. 598, 6. 028; 3. 055, 4. 586,4.572; 3.618, 5.860, 8.577; 2.300, 3.511, 3.943, P<0.05). The levels of FBG,GHbA1 and FCP in the 4 groups at 2 months after surgery were significantly different from those at 6 months after surgery (F = 4. 699,14. 378; 7.411, 29. 192; 3. 335, 9. 334, P < 0.05). The levels of FSI in the 4 groups at different time points were significantly different (F =2. 896, 7. 012, 11. 998, P < 0.05). Conclusion The efficacy of gastric bypass surgery for the treatment of nonobese type 2 diabetes mellitus is satisfactory.