[Objective]To explore the treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation.[Method]From February 2001 to August 2005,21cases of acute Lisfranc fracture-dislocations were treated with open reduction and cannulated screw fixation.[Result] According to the AOFAS for mid foot,1 case scored 70 to 80,3 cases scored 80 to 90 and 17 cases scored 90 to 100.[Conclusion]Treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation in early stage can lead to satisfactory reduction and clinical results,it is a satisfying method.

Objective To compare the curative effects of intertrochantefie fractures in aged by two operative methods. Methods 85 cases of elderly patients suffered from intertrechanteric fractures were retrospectively ana-lyzed. Out of the 85 cases,45 cases were treated with dynamic hip screw(DHS) and 40 cases were fixed with Gamma nails. The curative effects and complications were compared simultaneously. Results The total excellent rate was 83.5% in 85 patients,the rates of DHS and Gamma nails group were 77. 8% and 90% (X2 = 2. 84, P 0. 05), re-spectively. The operative time (66. 4 ± 19. 4)min in DHS group were less than the Gamma nail group (875 ± 25.5) rain (t=2. 451 ,P < 0. 05), but the length of surgical incision (19. 6± 5. 1)cm greater than the Gamma nail group (10. 3 ± 4. 7) cm(t = 2. 501, P < 0. 05). The complications of DHS group (11.1%) were significanfly higher than that of Gamma nail group(2. 5%) (X2 =3.94,P<0. 05). Conclusion As long as the physical condition can toler-ate,surgery recommend the use of DHS and Gamma nail surgical techniques in aged patients with intertrechanteric fractures.

[Objective] To observe the muscle relaxation clinical effect and the occurrence of intraoperative and postoperative complications,and the postoperative extubation and muscle strength recovery of Rocuronium and Succinylcholine in children during airway foreign body removal operation.[Methods] 80 cases of children (ASA I) with airway foreign body,among them,30 cases were older than 3 years old,were agreed to be on electively airway foreign body removal surgery.According to anesthesia induction,intravenous injection muscle relaxants were randomly divided into two groups (n =40):Rocuronium group (Group R) 0.9 mg/kg,Succinylcholine group (Group S) 1.5 mg/kg.According to the degree of muscle relaxation and operation time,if necessary,patients in Group R were added intravenous injection with Rocuronium 0.3 mg/kg,patients in Group S were added intravenous injection with Succinylcholine 0.5 mg/kg,the other drugs were consistent.Observation items included:the bronchoscopy conditions,the degree of muscle relaxation during operation,the numbers of intravenous injection muscle relaxant and atropine,the times of tracheal extubation,the dynamic observation about vital sign and hemodynamic intraoperative and postoperative,and the occurrence situation of complications,the incidence rate of muscle soreness in children older than 3 years old 24 h after operation.[Results] (1) There was no significant statistics difference between the two groups in the condition of bronchoscopy (P ＞ 0.05).(2)The patients in Group R were not required to add muscle relaxants and atropine,but all patients in Group S were required to add muscle relaxants and atropine (P ＜ 0.01).(3)The complications such as body movement,hypoxemia,restlessness during recovery period were happened in Group S,and in Group R,there were only 1 case of laryngeal spasm and restlessness during recovery period,there was statistically significant difference between the two groups (P ＜ 0.05).(4)The muscle strength recovery of 15 min in Group S was significantly higher than the Group R (P ＜ 0.01).(5) The time of tracheal cannula extubation was extended after the operation in Group R,there was statistically significant difference between the two groups (P ＜ 0.05).(6)30 cases patients older than 3 years old were followed up 24 h after operation,14 cases in Group S were found with the muscle soreness of trunk and limb,but none was found in 16 cases in Group R,there was statistically significant difference between the two groups (P ＜ 0.01).[Conclusions] The muscle relaxant effect was well during the removal of forcign body in children with Rocuronium and Succinylcholine,but the former provided a more security anesthesia condition,the muscle soreness of trunk and limb was not found in patient 24 h after operation;and the latter must continue to add drugs in operation,and the complications were found during and after the operation,the muscle soreness of trunk and limb was found in patient 24 h after operation.

Objective To study curative effect of core decompression and autologous bone marrow stem cell transplantation combined with traditional Chinese medicine in the treatment of early femoral head necrosis (ANFH).Methods 30 patients with femoral head necrosis treated by different methods were divided into 3 groups: core decompression A group) 10 cases(12 hips) ;core decompression pus stem cells transplantation(B group) 10 cases(13 hips) ;core decompression pus stem cells transplantation combined with traditional Chinese medicine(C group) 10 ca-ses( 10 hips) ;The X-ray 、CT MRI、Harris score( HHS) .curative effect were observed.Results The phase of Ⅰ,Ⅱ,Ⅲ,in 3 groups didn't appear deformation and collapse at 3,6,12 months;The score of Harris after 12 months 93 points were higher than that preoperatively 57.5 points(χ 2= 5.81 ,P<0.05) ;The signal ratio of femoral head volume in MRI was 42% before treatment,disappearance of femoral head necrosis after treatment;Total curative effect of B,C group,werehighter than that Agroup(χ2 =3.81,χ2 =3.98,P<0.05).Conclusion The operative treatment of ANFH with core decompression and stem cells transplantation combined with traditional Chinese medicine had the advantage of minimal damage,simplicity,accuracy,and effectiveness.

Objective To use clustering analysis to help physicians detect abnormal parameters in radiotherapy treatment plans and improve the efficiency of plan verification. Methods From 2010 to 2015, 835 breast cancer treatment plans for using 4?field hybrid intensity?modulated radiotherapy from MOSAIQ were collectted. Fractional dose, beam angle, and monitor unit were used as featured parameters of a treatment plan to generate a dataset. The K?means clustering algorithm based on principal component analysis was used to perform a clustering analysis of the dataset and divide the dataset into different clusters. The outliers of clusters were automatically detected based on the distance threshold. The outlier?contained treatment plans were manually verified by physicians to determine the accuracy of clustering analysis in detection of abnormal plans. Results In the clustering analysis, the sample space composed by parameters of treatment plans for breast cancer was divided into 4 clusters, 3 of which had outliers detected. In the targeted treatment plans, 3 plans became outliers because of special target volume and the other 4 plans needed improvement. Conclusions Clustering analysis is effective to help physicians to independently verify treatment plans.

Objective To detect genetic polymorphism of Toll like receptor 2 (TLR2) R753Q and Toll like receptor 4 (TLR4) D299G and T399I ,and to analyze its role and mechanism in the occurrence and development of colorectal carcinoma .Meth‐ods Totally 256 cases of patients with colorectal carcinoma and 256 cases of healthy control individuals were collected .The geno‐types of TLR2 R753Q ,TLR4 D299G and TLR4 T399I were detected by using PCR‐RFLP method .The levels of IL‐1α,IL‐8 ,MIP‐1αand MCP‐1 protein were detected by using ELISA .Results It is shown that TLR4 T399I was associated with the risk of color‐ectal cancer .The frequency of CT combined TT genotype of T399I in case group and control group was 31 .2% and 18 .7% ,respec‐tively .The frequency of T allele in case group and control group was 18 .2% and 10 .2% ,respectively ,and difference was statistical‐ly significant(P<0 .05) .Individuals with T allele of T399I showed a 2 .534‐fold increase in colorectal cancer risk compared with the T399I C allele(95% CI:1 .462-2 .734 ,P<0 .01) .There were significant differences in the expression levels of IL‐1αand MCP‐1 in colorectal carcinoma tissues of different genotypes .The expression level of IL‐1α in patients with CT combined TT genotype of T399I and those with CC genotype was (36 .97 ± 21 .43) and (22 .27 ± 17 .89)pg/mg respectively ,and the expression level of MCP‐1 was (24 .57 ± 17 .74) and (12 .91 ± 9 .78)pg/mg respectively .Conclusion T399I TLR4 is associated with the occurrence and de‐velopment of colorectal carcinoma ,and the risk of colorectal carcinoma in individuals with T genotype is significantly increased ,in which monitoring the expression of IL‐1 and MCP‐1 in colorectal carcinoma tissues might be the mechanism .

Objective To explore the epidemic situation of nontuberculous Mycobacteria in both Yuexiu and Zhuhai districts. Methods Mycobacterium tuberculosis culture and strain identification were conducted in suspected smear-positive tuberculosis patients who had visited our clinics at Yuexiu and Haizhu districts in Guangzhou during the period of 2010 to 2012. Results 2 014 sputum samples were identified as NTM and MTC, 1 630 samples were MTC (80.9%), and 384 samples were NTM (19.1%). The isolated rate for NTM from 2010 to 2012 was 17.6%, 17.1% and 21.2%, respectively. 79 strains of 384 NTM were identified; the rapid-growing mycobacterium was 50.6%, and the slow-growing mycobacterium was 49.4%. Conclusions The sputum-isolated rate of NTM for the suspected tuberculosis patients was 19.1% in Yuexiu and Haizhu districts in Guangzhou. For the smear-positive pulmonary tuberculosis patients who respond to treatment poorly , we should pay attention to NTM lung disease.

Objective To summarize the sonographic characteristics of high frequency ultrasound and elastography of thyroid microcarcinoma(TMC),and to analyze the causes of misdiagnosis.Methods The preoperative ultrasonic data of 245 suspicious TMCs in 202 patients,as confirmed by operation pathology,were retrospectively analyzed.Results Preoperative ultrasonography accurately diagnosed 221 TMCs,the diagnosis rate was 90.2％,and the misdiagnosis rate was 9.8％.Among the missed diagnosed lesions,18 lesions were nodular goiter,others were 3 nodular goiter with focal papillary hyperplasia of follicular epithelium,2 nodular goiter with adenomatous hyperplasia,1 focal lymphocytic thyroiditis,respectively.The thyroid lesions≤0.5 cm in diameter were more easily to misdiagnose.According to the importance of the ultrasonographic features of TMC,the order were aspect ratio (A/T) ≥ 1,irregular-shape,microcalcifications,low or very-low echo.Based on the above corresponding characteristics and considering other features together,the diagnostic accuracy rate were 94.1 ％,93.9％,92.4％ and 90.5％,respectively.Less blood supply and ill-defined boundary were the secondary sonographic signs of TMC.The elastographic scores of TMC were most showed 4 to 5 points.Diagnosis of TMC relied on elastography alone is less effective,but when elastograph diagnosis based on high frequency ultrasound,the diagnostic accuracy is much higher,especially when there is no calcification in the lesions.Conclusions High-frequency ultrasound has a very important value in the diagnosis of TMC,while elastography has certain assistant value on the basis of high-frequency ultrasonic diagnosis.

Background:Functional dyspepsia(FD)is a commonly seen functional disease which has great impact on patient’s quality of life and mental health,and has got more and more concern by clinicians. Aims:To explore the role of mast cells (MC)and plasma motilin( MTL)in the pathogenesis of FD. Methods:Sixty FD patients including 32 postprandial distress syndrome(PDS)and 28 epigastric pain syndrome(EPS)patients from September 2013 to January 2014 at the Affiliated Hospital of Putian University were enrolled,and 28 healthy volunteers were served as controls(HS group). The number of gastric mucosal MC,plasma MTL level(fasting and 30 minutes after drinking warm water)and gastric emptying time(T1 / 2 )were compared. Results:Compared with HS group,number of gastric mucosal MC was significantly increased (P < 0. 001),plasma MTL level before and after drinking warm water in FD group were significantly decreased( P <0. 001),T1 / 2 was significantly prolonged(P < 0. 001). No significant difference in number of MC was found between PDS subgroup and EPS subgroup(P = 0. 094). Plasma MTL level before and after drinking warm water in PDS subgroup were significantly lower than those in EPS subgroup( P < 0. 001),and T1 / 2 was significantly prolonged( P < 0. 001). Conclusions:Number of gastric mucosal MC is significantly increased in FD patients compared with HS group,suggesting MC may play a role in the pathogenesis of FD. Plasma MTL level is decreased in FD patients,which may be one of the factors involved in the pathogenesis and occurrence of corresponding symptoms of FD.

AIM: To estabolish the method for quality control of Anxinkang Dripping Pills(Radix Sophorae Flavescentis,Radix Astragali,etc.) METHODS: Using TLC to identify the dripping pills,matrine and oxymatrine in dripping pills were determined by RP-HPLC.Using C_(18) column,the mobile phase was made from the acetone methanol-H_3PO_4(3∶7∶90),the detection wavelength was at 210 nm. RESULTS: The herbs could be(identified) by TLC.For matrine,the linear range was from 0.05-0.50 ?g,and the average recovery was 97.3%,and for oxymatrine,the linear range was from 0.1-1.0 ?g,and the average recovery was 97.6%. CONCLUSION: The method is simple,reliable,accurate and can be applied to the quality control of the Anxinkang Dri-(pping) Pills.