Objective:To evaluate the effect of reduction by leverage with minimally invasive and internal fixation with Ideal Compression Screw to treat fracture of calcaneus.Methods:13 patients(17 fee)twith fracture of calcaneus were treated by reduction by leverage with minimally invasive and internal fixation with Ideal Compression Screw.According to Sanders'classification,10 sides were classified as typeⅡfracture and 7 sides as typeⅢfracture.Results:The post-operative functional evaluation by American Orthopaedic Foot and Ankle Society ankle score system revealed excellent outcomes in 12 feet(70.6%),good in 3(17.6%),fair in 2(11.8%).The excellent rate was 88.2%.Conclusion:Reduction by leverage with minimally invasive and internal fixation with Ideal Compression Screw to treat fracture of calcaneus is an effective and micro-invasive method in treatment of fractures of calcaneus.The technique can contribute to sta-ble fixation,low operation complication and high rate of excellent to good outcomes,et al.

Objective To investigate the role of glucocorticoid-induced tumor necrosis factor ligand (GITRL) in regulating the inflammatory reaction of kupffer cells.Methods The kupffer cells and T cells of mice were isolated and divided into 6 groups after being co-cultured:control group,kupffer cells and T cells were cultured in DMEM only; lipopolysaccharide (LPS) group,kupffer cells and T cells were cultured in media with LPS (1 mg/L) ; LPS + GITRL siRNA group,kupffer cells and T cells were cultured in media as the LPS group after transfected with GITRL siRNA ; LPS + control siRNA group,kupffer cells and T cells were cultured in media as the LPS group after transfected with control siRNA; LPS + pEGFP-N1 GITRL group,kupffer cells and T cells were cultured in media as the LPS group after transfected with pEGFP-N1 GITRL plasmid; LPS + pEGFP-N1 control group,kupffer cells and T cells were cultured in media as the LPS group after transfected with control plasmid.After 24 hours of treatment,the expressions of GITRL and PDL1 of kupffer cells were detected by immunofluorescence and western blot,respectively.The proliferation and apoptosis of T cells were measured by MTF assay and Annexin V/PI flow cytometry,respectively.The expression of tumor necrosis factor (TNF-α) in the supernatant fluid was measured by ELISA.All data were analyzed using the independent t test and one-way analysis of variance.Results The transfection efficiencies of GITRL siRNA and pEGFP-N1 GITRL were 90％ and 85％,respectively.Compared with normal kupffer cells,the protein expression of GITRL of kupffer cells transfected with GITRL siRNA was significantly decreased,while the protein expression of GITRL of kupffer cells transfected with pEGFP-N1 GITRL was significantly increased (t =41.72,13.10,P ＜ 0.05).There was no significant difference in the protein expressions of GITRL between normal kupffer cells and those in the control groups (F =2.27,P ＞ 0.05).The fluorescence intensity of GITRL in the LPS group was significantly higher than that in the control group (t =49.29,P ＜ 0.05).Compared with LPS group,the activation of GITRL expression by the LPS was significantly suppressed in the LPS + GITRL siRNA group (t =9.84,P ＜ 0.05),while the expression of GITRL in the LPS + pEGFP-N1 GITRL group was significantly increased (t =5.78,P ＜ 0.05).There was no significant difference in the GITRL expression among the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =0.86,P ＞ 0.05).The expression of PDL1 in the LPS group was significantly lower than that in the control group (t =18.83,P ＜0.05).Compared with LPS group,the expression of PDL1 in the LPS + pEGFP-N1 GITRL group was significantly suppressed (t =11.79,P ＜ 0.05),while the expression of PDL1 in the LPS + GITRL siRNA group was significantly stronger (t =19.08,P ＜ 0.05).There was no significantly difference in the expression of PDL1 in the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =2.22,P ＞ 0.05).The proliferation of T cells was increased and the number of apoptotic T cell was decreased in the LPS group when compared with control group (t =49.43,40.11,P ＜ 0.05).Compared with LPS group,the proliferation and apoptosis of T cells in the LPS + pEGFP-N1 GITRL group had the same trend (t =5.77,12.64,P ＜0.05); while the proliferation of T cells was decreased and the apoptosis of T cells was increased in the LPS + GITRL siRNA group (t =17.00,49.90,P ＜ 0.05).There was no significant difference in the proliferation and apoptosis of T cells among the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =1.87,1.35,P ＞ 0.05).The expression of TNF-α was significantly higher in the LPS group than that in the control group (t =125.68,P ＜ 0.05).Compared with the LPS group,the expression of TNF-α was significantly decreased in the LPS + GITRL siRNA group (t =119.65,P ＜ 0.05),while the expression of TNF-α in the LPS + pEGFP-N1 GITRL group was significantly increased (t =147.70,P ＜ 0.05).There was no significant difference in the TNF-α expression among the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =0.14,P ＞ 0.05).Conclusion Kupffer cells suppress the expression of PDL1 by upregulating GITRL,and thus activate the proliferation of T cells and promote the inflammatory reaction.The immunologic balance may be recovered after the interference of GITRL to restrain the inflammatory reaction.

The determination of tumor markers is of great value for esophageal squamous cell carcinoma. This article reviews the application status of routine tumor markers and the progression on the role of tumor markers in early diagnosis, predicting chemotherapy or radiotherapy response, monitoring disease recurrence and evaluation of prognosis in esophageal squamous cell carcinoma.

To serve as carriers of cells and bioactive molecules, three-dimensional scaffolds play a key role in bone defect repair. The chemical component and microstructure of the scaffold can affect the mechanical properties and seed cells. A variety of fabrication techniques have been used in producing scaffolds, some made random porous structure, some created well-designed structure using rapid prototyping methods, and others prepared bio-derived materials as scaffolds. However, scaffolds may vary in their inner structure, mechanical properties and repairing efficiency as well because of different manufacturing methods. In this review, we overview the main achievements concerning the effects of material and microstructure on the mechanical performance, seed cells and defect repair of bone scaffolds.
Biocompatible Materials ; Bone and Bones ; Porosity ; Tissue Scaffolds

A high sensitive hydride generation ( HG) atomic fluorescence spectrometric system was developed using high current microsecond pulsed hollow cathode lamp ( HCMP-HCL) as the excitation source and its performance was evaluated. Test results confirmed that the excitation source could give out intensive atomic spectral lines. System precision (RSD, n=7) was 1. 1% for arsenic and 1. 4% for selenium. Detection limits (DLs, 3) were 0. 0066 μg/L and 0. 0075 μg/L, respectively. The developed AFS system was proved to have high reliability, low detection limit and remarkable improvement of analysis capability compared with that of commercial AFS instruments.

Objective To analyse clinical effects and influence on serum creatinine and blood urea nitrogen of Danggui Niantong pill in treatment of gouty nephropathy. Methods 80 patients with gouty nephropathy were divided into two groups and each with 40 cases.The control group were treated with general therapy,and observation group was treated another with Danggui Niantong pill. Results After treatment,effective rate of observation group was 92.50％,higher than that of control group 72.50％(P<0.05).After treatment,renal function serum markers and urine related factors level of observation group were lower than control group(P<0.05).ESR,WBC and N level of observation group were lower than that of control group(P<0.05).The proportion of adverse reactions of observation group was 15.00％ and control group was 12.50％.Conclusion Danggui Niantong pill can improve clinical effects of gouty nephropathy,reduce renal damage amd does not increase adverse reactions.

Objective To explore the effect and mechanism of aerobic exercise on islet β-cells in type 2 diabetic rats.Methods Thirty healthy SPF 8-week old Wistar rats were randomly divided into control group (C, n=10), diabetic control groups (DMC) and diabetic exercise (DME) groups, 10 rats in each group, among which 7 successful rat models were used in the experiment.The diabetic rat model was established by high fat and sugar diet and i.p.injection of streptozotocin in a dose of 50 mg/kg.The rats of group DME were forced to perform 20 m/min running for 30 min, once a day, 6 days in a week, for 8 weeks.Other rats were allowed free movement.At the end of experiment, serum glucose and insulin were measured and homeostasis model assessment (HOMA) was calculated, and pancreatic tissue samples were collected for histopathological examination.The morphology and structure of pancreatic islets were observed under a digital microscope, the perimeter and area of islets were analyzed by image analysis, and shape factor of islets was calculated.The insulin content, glucokinase and ultramicro-ATPase activity in the pancreatic homogenate were determined.Results In the DME group, the perimeter and area of islets were significantly higher than the DMC group (P< 0.05), but still lower than the control group.The shape factor was significantly increased, the cell hypertrophy, vacuolization and nuclear pyknosis were markedly alleviated than those in the DMC group, the insulin content, glucokinase and the trace total ATP activity in the DME group were significantly higher than those in the DMC group (P<0.05), and the SF and HOMA were significantly changed.Conclusions Aerobic exercise can reduce the blood glucose level, improve the morphology of islets and β-cells in the type 2 diabetic rats.It may be due to increase of the activity of glucose kinase and ATP-synthase, and increased insulin sensitivity in the pancreas.

Objective To explore the effects of puerarin on proliferation ,invasion ,migration and tube formation in human endo-thelial cells and its possible mechanism .Methods The effect of puerarin on cell proliferation was determined using methyl thiazolyl tetrazolium(MTT) assay .Invasion was evaluated with transwell chamber .Migration was performed by the wound healing method . Endothelial tube formation was performed by tube formation assay .The expressions of phosphorylase Akt(p-Akt) and phosphoryl-ase nitric oxide synthase(p-eNOS) protein were determined by western blot .Results Puerarin promote the proliferation ,invasion , migration and tube formation of human endothelial cells(P<0 .05) .The expression of p-Akt and p-eNOS were increased signifi-cantly(P<0 .05) .Conclusion Puerarin can promote the proliferation ,invasion ,migration and tube formation of human endothelial cells .Up regulation of p-AKT and p-eNOS protein may be one of its mechanisms .

Objective To discuss surgical techniques of laparoscopic treatment for intrahepatic stones.Methods A total of 57 cases of intrahepatic stones from March 2000 to March 2005 were studied. Under laparoscopic visualization,openings of left and right hepatic bile ducts were exposed through a longitudinal incision in the common hepatic duct to the bifurcation of left and right hepatic ducts.Stones in left and right hepatic bile ducts were evacuated with the use of a lithotomy forceps,a tiny basket,or pressure irrigation.Then openings of secondary hepatic ducts were exposed through the dilated primary ducts for the removal of stones in secondary hepatic ducts.Sometimes even openings of tertiary hepatic ducts could be seen for stone removal.When mud-or sand-like calculi were encountered,repeated irrigation of bile ducts was carried out.Results Conversions to open surgery were required in 3 cases(3/57,5.3%).The time of operation was 75～275 min(136?54 min).Residual stones were found in 49 cases(49/57,86.0%),which required postoperative choledochoscopy for 1~4 times to clear the intrahepatic stones.Complete clearance of all intrahepatic stones was achieved in 53 cases(53/57,93.0%).In 2 cases of calculi impacted in the lower common bile duct,laparoscopic electrohydraulic lithotripsy was performed for stone extraction.Postoperative bile leakage occurred in 5 cases(5/57,8.8%),and was cured with tube drainage.Follow-up observations for 0.5~5 years(2.3+1.5 years) in 43 cases showed excellent outcomes in 38 cases(88.4%),good outcomes in 3 cases(7.0%),and poor in 2(4.6%).Conclusions Intrahepatic stones can be removed laparoscopically through a longitudinal incision in the common hepatic duct to the bifurcation of left and right hepatic ducts for the exposure of primary and secondary hepatic ducts,or even tertiary hepatic ducts.

Objective To describe the experience of nurses in combined care program of traditional Chinese medicine (TCM) and provide references for nursing managers. Methods The phenomenology research method was adopted in this study. Fourteen nurses who had achieved the combined care program of TCM participated in an in-depth interview. Data were analyzed by using phenomenological analysis. Results All nurses approved nursing program of TCM: finding sense of belonging in nursing work;demonstration of self-value;standardization of nursing tednnique;harmonious environmont of nursing work. But some defect still existed: too subjective evaluation item of nursing program of TCM;inappropriate evaluation table;lact of hospital characteristics of TCM nursing;deficiency of TCM knowledge. Conclusion Nursing managers should pay more attention to nurses' emotional experience, grasp the implementation of the problems during the program and improve the program, optimize the skills, provide trainings.