BACKGROUND:Traditional studies on foot and ankle biomechanics have limitation. Ankle joint was complicated and had big range of motion, so it is difficult to establish finite element models and to analyze the type of fracture.
OBJECTIVE: To construct the finite element models of distal tibial fractures and analyze the stability.
METHODS: CT data of ankle were colected from a normal male volunteer and the three-dimensional reconstruction of volunteer was made by Mimics software, and the effectiveness was verified. The ratio of different joint involvement and height of fracture block were assumed with Solidwork software, and finite element models of distal tibial fractures were established. Fracture stability was analyzed by ANSYS software using finite element method.
RESULTS AND CONCLUSION:The distal tibia fracture model was consistent with the relevant literature data, and finite element analysis could be further conducted. The ratio of articular surface involved was positively associated with fragment height and fracture displacement, and negatively associated with fracture stability. These results indicate that the three-dimensional finite element models of distal tibial fractures were successfuly established. Fracture stability was associated with the ratio of articular surface involved and fragment height.

Objective To study the risk factors of pulmonary embolism and comparison of the effect of different therapy.Methods Risk factors of 182 patients with pulmonary embolism were analyzed retrospectively.The patients were randomly divided into simple drug group and drug joint intervention group.Simple drug group was given heparin and warfarin,or jiont urokinase fibrinolytic therapy.The drug joint intervention group was given the same drug therapy joint vena cava filter implantation and/or catheter broken bolt therapy.After different treatment,the clinical prognosis was compared between the two groups.Results Of 182 patients with pulmonary embolism,the elderly and smoking prevalence rate increased significantly,deep vein thrombosis,cardiovascular disease,cancer,blood system diseases,trauma and surgery,chronic lung disease,fracture and orthopaedic surgery were the main risk factors.The effective rate and mortality between the pure drug therapy group and drug joint intervention group had no significant differences(x2 =0.145,P ＞ 0.05).Conclusion The incidence of pulmonary embolism is closely related to the risk factors.Cancer is one of the important diseases caused by pulmonary embolism.In a timely manner to give the antithrombotic drug treatment has great significance to the prognosis of pulmonary thromboembolism,there was no significant difference compared with the antithrombotic joint intervention.

Objective To explore the treatment of sepsis in patients with severe sepsis, the use of CBP (continuous blood purification) effect on lactic acid and hemodynamics in patients with blood.MethodsIn 40 cases of patients with severe sepsis treated by conventional methods, and classified as the control group, the other 40 patients using CBP (continuous blood purification treatment;blood lactic acid) after evaluation and hemodynamics of two groups of patients before and after treatment, and compared between groups, the patients were treated in our hospital from January 2015 to October 2016.ResultsThere was no significant difference in blood lactate level of the two groups of patients before treatment, after grouping After treatment, the patients in the observation group decreased more significantly, while the monitoring of patients in different time period, showed its obvious difference;hemodynamics of two groups were observed and compared, found before treatment all indexes had no significant difference after the treatment group were improved more obviously in patients in the observation group, group are P<0.05 shows obvious differences.ConclusionAnalysis of the influence of the dynamics of CBP in severe sepsis patients blood lactic acid and blood flow, which can significantly improve the patient's level of lactic acid, which decreased gradually, while helping the hemodynamic situation of the patient to recover, it is worthy of reference.

Objective To observe the ultrastructural changes in the midgut epithelium of Ixodes sinensis after infesting rabbits immunized with {Mr 105 000} purified tick antigen. MethodsNew Zealand rabbits were inoculated with {Mr 105 000} purified antigen by means of mutiple intradermal injection in foot pad, groin and back. Each immunized rabbit was infested by 30 female Ixodes sinensis. At 24 hours, 48 hours, 72 hours, 5 days and 8 days after infestation, three Ixodes sinensis in each group were observed for ultrastructural changes in the epithelium of their midgut. Results Histological examinations showed that with the time going, digestive cells of the ticks after infesting hosts became more and larger with dense and regularly arranged microvilli, enriched organella, distinct unit_membrane structure, and the appearance of tubli, small vacuole, numerous lipid droplets and hematin granules. These cells also developed a highly infolded basal lamina, forming a labyrinth system. The digestive cells of immunized group were however greatly damaged, whose number and volume were significantly different from control groups. From 24 to 48 hours after infestation, the midgut epithelium of Ixodes sinensis showed pathological changes with the basal lamina becoming thinner, looser and broken; digestive cells damaged and vacuolated; microvilli decreased, shortened and irregularly arranged; the mitochondria swollen and its crests reduced, shortened and even with myeloid changes; the rough endoplasmic reticulum dilated; lipid droplets and hematin granules decreased; phagocytic and pinocytic activity weakened; and basal labyrinth system vacuolated. From 72 hours to 8 days after infestation, cells were severely damaged, organella were denatured and necrotic, nuclei showed pyknosis and cells lysed. Conclusion The rabbits immunized with {Mr 105 000} purified ixodic protein have acquired the adoptive immunity against Ixodes sinensis; in the anti_tick immunity described above, the midgut of Ixodes sinensis is the major affected site.

Objective: The Phenomenon of different species with the same name has created potential threats to cinical safety of medication. Because of that, two kinds of “gonglao leaf” and their sibling adulterants have been identified by molecular methods in this study, to secure its safety in medication. Methods: Ilexcornuta, Mahoniabealei, Mahoniafortuneiand their sibling adulterants total of 9 species 45 samples were collected in this experiment,Total genomic DNA was extracted from them by the method of improved CTAB, ITS2 sequences were amplified, and the PCR products were sequenced. Sequence assembly and consensus sequence generation were performed by the CodonCode Aligner V 4.2.4.. The genetic distances were computed by MEGA 6.0 in accordance with the Kimura 2-Parameter (K2P) model and the phylogenetic tree constructed by the neighbor-joining (NJ) method. Results: The analysis results of the genetic distances, variable sites and the NJ phylogenetic tree showed that Ilexcornuta, Mahoniabealei, Mahoniafortunei were seperated from their sibling adulterants obviously. Conclusion: ITS2 sequence was able to identify two kinds of “gonglao leaf” and their sibling adulterants which can provide a basis for clinical accurate medication.

Objective To investigate the lung function testing performing in normal smokers,and urge smokers to stop smoking early. Methods Two hundred and one adult men did the pulmonary function testing by MINATO AS-505 portable spirometer, and analyzed the effect d different smoking degree on the pulmonary function. Results There was no relationship between lung volume index and smoking, smoking degree. Compared with nonsmokers, the indicants such as FEV1, MVV, FEV1/FVC had decreased, and the indexes of the small airway function (PEF, FEF25%-75%)had significantly dropped in the smokers. And the smokers especially long-term smokers, most indexes of the pulmonary functions and all indexes of the small airway function correlated with smoking index. Conclusion Although smokers do not show clinical symptoms, their lung functions have been reduced, especially small airway function.

Objective To explore the relationship between R time in thrombelastography (TEG) and prognosis of traumatic brain injury (TBI).Methods The data of TBI patients were collected in Fourth Peoples Hospital in Shaanxi Province from January 2015 to June 2016.The patients were divided into two groups according to the prolongation of R time at admission,and the basic data and the outcomes were analyzed.Results In basic data,Glasgow coma scale (GCS) [(9.7 ± 4.4) scores vs (12.1 ± 2.2) scores] was lower,and injury severity score (ISS) [(32.4 ± 8.9) scores vs (21.7 ± 10.4) scores],head abbreviated injury scale (AIS) [(5.0 ±0.0) scores vs (4.1 ± 1.5) scores],hemorrhage volume [(6.2 ± 5.5) ml vs (1.1 ± 1.8) ml] and mean arterial pressure[(127.2 ± 28.1) mmHg vs (103.3 ± 17.0) mmHg] were higher in the prolonged R time group.In outcomes,the in-hospital mortality (42.9％ vs 17.2％) and the rate of neurosurgical intervention (71.4％ vs 37.7％) were higher,and the duration of mechanically ventilated [(9.3 ±3.2) d vs (4.1 ± 1.7) d],ICU stay [(10.2 ± 4.4) d vs (5.6 ± 2.1) d] and hospital stay [(22.4 ± 8.1) d vs (8.3 ± 4.7) d] were longer in prolonged R time group.The Logistic regression analysis results showed that GCS ≤8 scores,ISS ＞ 25 scores and R time ＞ 10 min were the possible risk factors of hospital mortality.Conclusion TBI patients with longer R time have worse prognosis and longer R time is the possible risk factor of hospital mortality,and the prediction efficiency of R time need to be explored and validated by more research.

Objective To prepare dual-targeted microbubbles carrying both anti-CD34 monoclonal antibody and anti-ICAM-1 monoclonal antibody,to identify its basic characteristics,and to investigate its targeting performance in vitro.Methods ICAM-1-targeted microbubbles (MgIcAM-1),CD34-targeted microbubbles(MBcD34) and dual-targeted (with both monoclonal antibodies) microbubbles (MBD) were prepared by biotin-avidin bridging chemistry method.The targeted microbubbles were observed under light microscrope and characterized by a Mastersizer 3000,DFY software,laser confocal microscopy,and flow cytometry.The targeting specificity and attachment capability of dual-targeted microbubbles to endothelial progenitor cells (EPCs) and damaged human umbilical vein endothelial cells (HUVECs) were assessed in vitro.Results The morphous,diameter,surface potential,concentration,and the antibody-binding rates of microbubbles were not statistically significant in MBIcAM-1,MBCD34,and MBD (P ＞0.05).Echo intensity in MBD significantly increased compared with MBICAM1,MBCD34,and MBiotin (P ＜ 0.01).The targeting experiment in vitro showed that the attachment rate of MBD to EPCs and damaged HUVECs significantly increased compared with MBiotin (P ＜0.01),while no remarkable difference in attachment rate was found between MBD and MBcD34 in EPCs,and between MBD and MBIcAM-1 in damaged HUVECs (P ＞0.05).Conclusions Dual-targeted microbubbles carrying both anti-CD34 monoclonal antibody and anti-ICAM-1 monoclonal antibody are prepared successfully.The study in vitro has proved that the dual-targeted microbubbles can specifically bind to both EPCs and damaged HUVECs.

Objective To summarize the clinical features, diagnosis and treatment of Ménétrier disease in China. Methods A systematic review of Ménétrier disease in China was performed. Four electronic databases were searched from 1993 to 2008 including CNKI and Wanfang seeking studies about pathologically performed Ménétrier disease. Results Data of 95 patients with Ménétrier disease from 62 studies was included. There were 74 males and 21 females. The mean age of onset in adults was (47.4± 5.3) years . The process of the disease was longer in male individuals that in female individals (47.5 months vs. 13.7 months, P<0.05). The main symptoms included abdominal pain (76.8%), weight loss (42.1%), anorexia (40.0%) and edema of lower extremities (36.8%), etc.Hypoproteinemia was accounted for 71.6 % and most of the patients had hypochlorhydria. The typical giant hyperplastic gastric fold was found in 88.4 % of the patients under endoscopy. The diffuse type was in predominance and mainly involved the greater curve of the stomach (55.3 %). Whereas 5.3 patients were accompanied with gastric cancer. The misdiagnostic rate of the disease was 31. 6%,which accounted for 50% in surgically treated patients. Conclusions In China, the Ménétrier disease is predominant in middle-aged males, and the process is longer in males than in females. Misdiagnosis is related to existence of weight loss and hypoproteinemia. Most of the patients with Ménétrier disease have a good prognosis even the disease process is long.