OBJECTIVETo discuss the treatment strategy of acetabular fractures and unstable pelvic fracture of the hip and to evaluate its outcome.

METHODSRetrospective analysis of clinical data in 32 patients with unstable pelvic fracture and acetabular fractures from January 2007 to June 2013 were collected. There were 18 males and 14 females aged from 18 to 62 years old (means 38 years old). According to Tile classification of pelvic fracture, 11 cases were type B1, 8 were type B2.1, 7 were type B2.2, 3 were type C1.1, 2 were type C1.2, 1 was type C3. According to Judet-Letournel classification, anterior column fracture was in 1 case, transverse fracture in 8, transverse plus posterior wall fracture in 6, T-type fracture in 1, anterior column plus half transverse fractures in 5, double column fracture in 11. Other combined injuries were treated early, the surgical operation were performed after stable condition. The hip joint function and the fracture reduction were assessed during follow-up.

RESULTSThe operative time was from 1.8 to 6.5 hours (averaged 3 hours). Two fat patients' incision occurred in fat liquefaction and healed after dressing, no incision infection happened. Only 1 case was lost to follow-up, 31 patients were followed up with a mean time of 23 months (6 to 42 months). The healing time of pelvic fracture was from 8 to 18 weeks (averaged in 10.6 weeks). The hip function was evaluated according to the Matta and Tornetta standard postoperatively, the result was excellent in 15 cases, good in 14 cases, fair and poor in 1 case respectively. The Majeed score of the hip function was 83.65? 7.67, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The healing time of acetabular fractures was from 8 to 16 weeks (averaged in 10.2 weeks). The fracture reduction was assessed by Matta standard, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The heterotopic ossification was evaluated by Brooker standard, 4 cases were grade I, 1 case was grade II . There were no infection, nonunion and necrosis of the femoral head in all patients. The nerve damage symptoms in 5 patients disappeared during 4 to 6 months after operation.

CONCLUSIONPatients with unstable pelvic fractures and acetabulum fractures were in a critical condition early, using the concept of damage control to save lives in a timely manner. Grasp the operation time in the late treatment, acetabulum fractures reach anatomical reduction as far as possible, pelvic fractures are given priority to stable reconstruction. The operation order was fixed pelvic ring first, according to the condition to choose the appropriate surgical approach and fixed mode.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUND:Immunosuppressants fight against acute rejections by influencing humoral and celular immune to suppress the immune function, and then improve patient/renal graft survival. OBJECTIVE:To evaluate the effectiveness and safety of alemtuzumab, daclizumab and antithymocyte globulin in inducing immunosuppression in kidney transplantation. METHODS:The randomized controled trials of alemtuzumab or daclizumabversusATG in kidney tranplantation published from 1966 to 2011 were enroled by searching PubMed and EMBASE using Cochrane systematic review. We colected data and major outcomes. And a meta-analysis was conducted on homogeneous studies. RESULTS AND CONCLUSION: A total of 9 randomized controled trials (777 patients) about kidney transplantation were included. The meta-analysis results showed that the safety items including patient/renal graft survival and acute rejection at a folow-up of 24 months had no statistical differences among the three drugs (al P > 0.05). But there was a significant difference between the infection rates of alemtuzumab and antithymocyte globulin at 36 months of folow-up (P < 0.05). The results indicate that alemtuzumab, daclizumab and antithymocyte globulin are equaly effective in inducing immunosuppression at a folow-up of 24 months in kidney transplantation. However, compared to antithymocyte globulin, alemtuzumab has a lower rate of infection at a folow-up of 36 months.

ObjectiveTo determine the cerebral protection effect and mechanism of propofol on global cerebral ischemia and reperfusion damage in rats.Methods19 adult male Wistar rats were randomly divided into 3 groups, ischemia group (n=7), propofol group (n=7), and sham injury group (n=5). Global cerebral ischemia and reperfusion model were made by means of Pulsinelli's method. Rats in propofol group were anesthesia with propofol at the dosage of 1.5 ml/h for 30 min at the beginning of reperfusion. Apoptosis and necrosis rate were detected by cytometry. In the same time, bcl-2, Bax and p53 protein expression in hippocampus neurons were detected. ResultsThe apoptosis and necrosis rate in propofol group were significantly decreased as compared with ischemia group ( P<0.05). Bax and p53 protein expression in hippocampus neurons were also significantly decreased as compared with ischemia group (P<0.05), however, no significant findings in bcl-2 protein expression (P>0.05).ConclusionPropofol can decrease apoptosis and necrosis rate in cerebral ischemia reperfusion injured neuron, and the mechanism maybe related to decreasing the expression of Bax, p53 protein.

Objective To investigate the incidence of hearing disorder and analyse the high-risk factors with hearing injury in newborns with hyperbilirubinemia.Methods The newborns with hyperbilirubinemia who admitted to the department of neonate,were received the distortion product otoacoustic emission(DPOAE)test when they recovered from hyperbilirubinemia;those babies who didn′t pass the first test received screening again in 42 days after birth.Those babies who didn′t pass the second test received auditory brain stem response(ABR)test.Results Fifty-eight(33.2%)newborns didn′t pass the first DPOAE test among 235 newborns with hyperbilirubinemia;11(18.9%)infants didn′t pass the second DPOAE test among 58 infants;5 infants failed to pass the ABR test,the ratio of hea-ring disorder in newborns with hyperbilirubinemia was 2.13%;18(9.9%)newborns didn′t pass the first DPOAE test among 182 normal newborns,and those infants all passed the second DPOAE test.Conclusions Hyperbilirubinemia is high-risk population of hearing disorder.The congenital cytomegalovirus infection,neonatal septicemia and hemolytic disease of newborn are the high risk factors responsible for hearing disorder.All high risk newborns should recieve hearing examination regularly.

Objective To investigate water fluoride content and the current status of water-improving project in Jining,Shandong Province in 2005.Methods Water fluoride content and the status of water-lmprovlng project were havestigated in Bencheng Ditrict,Liangshan and Jiaxiang Couties of Jining City.The fluoride content in drinking warer was assessed by F-ion selective electrode.Results Water fluoride contents of 671 fluorosis villages were determined.One hundred and seventy villages had water fluoride content less than or equal to 1.00 mg/L(accounting for 25.34%)and 501 villages water fluoride content higher that 1.00 mg/L(accounting for 74.66%),with the highest being 11.33 mg/L.Four hundred and ninty.seven projects were surveyed,in which 161 Projects were discarded (accounting for 32.39%),334 projeets worked well(accounting for 67.20%),and 2 pmjects worked fitfully(accounting 0.40%).Two hundreds and eighty-one projects had water fluoride content≤1.00 ms/L and 55 projects had water fluofide cantent>1.00 mg/L(aceounting for 26.82%),with the highest being 4.28 ms/L.Conclusions The situation of endemic fluorosis control is still serious in Jining City.Countermeasures for endemic fluorosis must be carried out as sppm as possible and surveillance of water-improving and defluoridation projects must be strevIsthend.

?AIM:To evaluate the incidence and clinical properties of dry eye after phacoemulsification in age-related cataract patients.?METHODS: Samples were collected from 145 age -related cataract patients (145 eyes).Dry eye was analyzed at 0, 7, 30, 90 and 180d after phacoemulsification by 1 ) Ocular Surface Disease Index questionnaire ( OSDI ) , 2 ) tear meniscus height ( TMH ) , 3 ) corneal fluorescein staining, 4) tear film break-up time (BUT), 5)SchirmerⅠtest( SⅠt) .?RESULTS:The symptoms and signs of dry eye, such as narrowing of TMH, shorting of BUT, decreasing of SⅠt, cornea staining by fluorescein, occurred as early as 7d post-phacoemulsification and were measured by OSDI questionnaire and 4 additional clinical tests.Over the six-month observation the severity of dry eye peaked at 30d and then gradually relieved.? CONCLUSION: The severity of dry eye after phacoemulsification peaked at 30d and gradually improved over time. Considering the characteristics of ocular surface for aged people ophthalmologists should pay more concern on evaluating the occurring of dry eye after phacoemulsification so as to improve the life quality of these people.

OBJECTIVETo investigate the effects of combined application of Xuezhikang Capsule (XZK) and hypotensive drugs on the dynamic blood pressure (DBP), pulse pressure index (PPI), pulse wave velocity (PWV) and smoothness index (SI), and to study the relationship between SI and related factors (age, BP, dynamic PPI, and vascular elasticity).

METHODSOne hundred and ten patients with essential hypertension were randomly assigned to 2 groups: 54 in the control group and 56 in the treated group. Both were treated with hypertensive drugs, but with oral medication of XZK given additionally to the treated group at the dose of 60 mg, twice a day. PWV and DBP were measured before treatment and at the terminal of a 6-month treatment. Meantime, the 24-h average systolic and diastolic pressures were recorded to calculate the 24-h dynamic pulse pressure (24 hPP), PPI, SI of systolic and diastolic blood pressure (SISBP and SIDBP) for comparing the changes between groups and analyzing the SI related factors.

RESULTSAll patients' blood pressure levels were well controlled; after a 6-month treatment, the PP and PPI in the treated group were 45 +/- 8 mm Hg and 0.35 +/- 0.08 respectively, which were significantly lower than those in the control group (51 +/- 10 mm Hg and 0.38 +/- 0.05, P < 0.05); while SISBP and SIDBP in the treated group were higher than those in the control group (1.37 +/- 0.16 vs 1.26 +/- 0.20, P < 0.01; and 1.28 +/- 0.14 vs 1.18 +/- 0.23, P < 0.05) respectively; and PWV in the former was significantly lower than that in the latter group (10.4 +/- 3.68 m/s vs 12.5 +/- 4.27 m/s, P < 0.05). Multiple factor stepwise regression analysis showed that the SISBP was negatively correlated with age, PPI and PWV, while the SIDBP was negatively correlated with PPI (P < 0.01).

CONCLUSIONThe combined application of XZK and hypotensive drugs can decrease PP and PPI, improve the endothelial function and arterial elasticity, enhance the efficacy of treatment on SI. After treatment SI shows a significant negative correlation with PPI, PWV and age in patients.

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Arteries ; drug effects ; physiopathology ; Blood Pressure ; drug effects ; Compliance ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Middle Aged ; Phytotherapy

In order to efficiently control the quality of the Tibetan medicine Gentianae Szechenyii Flos, the quality standard was established in this study. The tests of water content, total ash and ethanol-soluble extractives of the crude drugs were carried out based on the methods recorded in appendix of Chinese Pharmacopeia (2010 edition, volume 1). The TLC method was established by using reference drug and gentiournoside A as reference substance, and a mixture of ethyl acetate-methanol-water-formic acid (7: 1.5: 1: 0.2) as the developing solvent system on silica gel G TLC plate. The content of gentiournoside A was assayed by HPLC on a Ultimate XB-C18 (4.6 mm x 250 mm, 5 μm) column, using methanol-water (0.02% phosphoric acid) (52:48) as the mobile phase at a flow rate of 1.0 mL x min(-1). The column temperature is 25 degrees C and the detection wavelength is at 240 nm. As a result, gentiournoside A and the other constituents were separated and presented the same fluorescence light comparing with the reference substance on TLC detected under the UV light(366 nm). The methodology validation for the assay of gentiournoside A showed that it was in a good linear correlation in the range of 10.01-400.32 mg x L(-1) with the regression equation of Y = 1 539.5X - 33.339 (r = 0.999 7), and the average recovery was 99.68% (RSD 1.92%). The mass fractions of gentiournoside A, water content, ethanol-soluble extractives of 19 batches samples were varied in the ranges of 14.48-31.51 mg x g(-1), 11.25% -12.74% and 24.21% - 31.60%, respectively, and total ash was 4.64% - 6.12% detected from 10 batches samples. The recommended standards of quantitative indexes are that the mass fractions of gentiournoside A and extractives are not less than 15.0 mg x g(-1) (1.5%) and 21.0%, respectively; the water and total ash are not more than 13.0% and 6.0%, respectively.
Chromatography, High Pressure Liquid ; Chromatography, Thin Layer ; Drugs, Chinese Herbal ; chemistry ; standards ; Flowers ; chemistry ; Gentiana ; chemistry ; Medicine, Tibetan Traditional ; Quality Control

Gentianae Urnulae Herba, dried whole herb of Gentiana urnula,is a commonly used Tibetan medicine. However, only the character identification is used as quality control standard officially at present. As a part of project for the Chinese Pharmacopoeia (2015 edition), the quality standard of this species was established in this study. The tests of water content, total ash, acid-insoluble ash and ethanol-soluble extractives of the crude drugs were carried out following the methods recorded in appendix of Chinese Pharmacopeia (2010 edition, volume 1). The TLC identification method was established by using gentiournoside A as reference substance, and a mixture of ethyl acetate-methanol-water-formic acid(7:1. 5:1: 0. 2) as the developing solvent system on silica gel G TLC plate. The content of gentiournoside A was assayed by HPLC on an Agilent Zorbax SB-C18 (4.6 mm x 250 mm,5 μm) column, using acetonitrile-water (0.1% phosphoric acid) (26:74) as the mobile phase at a flow rate of 1.0 mL x min(-1). The column temperature is at 30 degrees C and the detection wavelength is at 240 nm. As a result, gentiournoside A and the other constituents were separated and presented the same fluorescence light comparing with the reference substance on TLC detected under the UV light(366 nm). The methodology validation for the assay of gentiournoside A showed that it was in a good linear correlation in the range of 0.009 95-0.398 g x L(-1) with the regression equation of Y = 1 467.1X +41.407(r = 0.999 9), and the average recovery was 98. 3% (RSD 2.2%). The mass fractions of gentiournoside A, water content, ethanol-soluble extractives of 15 batches samples were varied in the ranges of 0.175% -1.83%, 8.60% - 9.93% and 29.2% - 35.2%, respectively. Total ash and acid-insoluble ash were 10.2% - 17.2% and 5.26% - 10.8% detected from 10 batches samples. The recommended standards of quantitative indexes are that the mass fractions of gentiournoside A and extractives are not less than 0.80% and 26.0%, respectively; the water, total ash and acid-insoluble ash are not more than 12.0%, 15.0% and 8.0%, respectively.
China ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; standards ; Humans ; Medicine, Tibetan Traditional ; standards ; Plants, Medicinal ; chemistry ; Quality Control

BACKGROUND:Nano-silver is a new antibacterial material developed based on nano-technology. It is characterized as stable physical and chemical properties, and good electrical, optical, and catalytic performance, but its antibacterial response to Staphylococcus aureus is controversial. OBJECTIVE:To explore the preparation methods of nano-silver coating on pure titanium surface and to explore its antibacterial effect on Staphylococcus aureus. METHODS:(1) Preparation of nano-silver coating on the surface of pure titanium: Hydroxyapatite and silver powder as research objects were fully mixed at a ratio of 20:1. The mixture was ball-milled to ensure the formation of nanosized particles. The mixture of hydroxyapatite and silver powder was put into a stirrer for continuous stirring to ensure the uniform distribution. The mixture was then placed in an ethanol solution followed by insertion of a titanium plate (anode) and a stainless steel plate (cathode). The precipitated powder was obtained on the titanium surface at a voltage of 20 V, and the pure titanium surface with nano-silver coating was prepared after heat treatment in a tube resistance furnace. (2) Observation of antibacterial properties: A minimal inhibitory concentration test was used to determine the antibacterial concentration of the nano-silver coating on the pure titanium surface when shaken with Staphylococcus aureus. A scanning electron microscope was used to observe the structure of Staphylococcus aureus on the pure titanium surface with nano-silver coatings of different mass concentrations. RESULTS AND CONCLUSION:Nano-silver/hydroxyapatite composite coating and hydroxyapatite coating were relatively uniform. The nano-silver/hydroxyapatite composite coating was white in color but slightly yellowish. The hydroxyapatite coating was white in color. The coating surface was rough and bonded firmly. No peeling of the coating was observed under gross observation. The antibacterial ability of the nano-silver group at 37℃ static culture and at 37℃ shaking culture was significantly higher than that of the hydroxy-apatite group (P<0.05). The absorbance value of Staphylococcus aureus at 600 nm in the nano-silver group was lower than that of hydroxyapatite group at 7, 10, 30 hours after intervention (P<0.05). The layer cells on the nano-silver coating become lighter in color compared with those on the hydroxyapatite coating and there were cells that ruptured and died. The number of Staphylococcus aureus on the nano-silver coating was reduced, and a large number of vacuoles were found. These findings indicate that the 20:1 mixture of hydroxyapatite and silver at micron level can be used to prepare nano-silver coating through ball milling, water bath, ultrasound and heat treatment. The prepared coating can exert excellent antibacterial effects on Staphylococcus aureus.