BACKGROUND:Manual reduction or traditional steel plate fixation is commonly used for repair of proximal humerus factures in older patients, because of poor stability, making these injuries prone to fracture malunion. While open reduction with steel plate fixation has a better outcome than closed reduction, the stability of internal fixation is stil less than satisfactory. Clinical studies have shown that minimal y invasive treatment with locking compression plates has presented good clinical results in terms of fixation stability, bone healing, and functional recovery. Therefore, we hypothesize that use of a locking compression plate wil provide better stability and that biocompatibility wil potentiate fracture healing and shoulder function recovery in older patients with proximal humerus fractures. OBJECTIVE:To observe the improvement of minimal y invasive treatment with locking compression plates in older patients with proximal humerus fractures. MEHTODS:This prospective, single-center, randomized control ed clinical trial wil be completed at the Department of Joint Surgery, Affiliated Hospital of Qinghai University in China. Eighty-two older patients with proximal humerus fractures wil be enrol ed and equivalently assigned to two groups. In the test group, patients wil undergo closed reduction via a lateral approach to the shoulder fol owed by locking compression plate fixation using a minimal y invasive technique, and those in the control group wil be subjected to closed reduction via a lateral approach to the shoulder fol owed by conventional steel plate fixation using a minimal y invasive technique. Al patients wil be fol owed up for 6 months. The primary outcome wil be recovery of shoulder function as indicated by clinical outcome scores according to the Neer classification system for proximal humeral fractures 6 months after surgery. The secondary outcomes wil include the operation time;intraoperative blood loss;postoperative hospital stay;fracture healing time;clinical outcome scores according to the Neer classification system 0.5, 1, and 3 months after surgery;visual analogue scale scores 1 and 3 days and 1 and 2 weeks after surgery to assess pain;scores of the Medical Outcomes Study 36-item short form health survey 0.5, 1, 3, and 6 months after surgery to assess quality of life;and X-ray examinations 0.5, 1, 3, and 6 months after surgery to assess fracture healing. The experiment was approved by the Ethics Committee of Affiliated Hospital of Qinghai University of China (approval No. QHY1005D). Participants were informed to the test content and treatment process, and signed informed consent. DISCUSSION:This study protocol represents an attempt to objectively choose appropriate methods for internal fixation of proximal humerus fractures in older patients by comparing locking compression plate and conventional steel plate fixation to improve shoulder function. TRIAL REGISTRATION:This trial was registered with the ClinicalTrials.gov identifier:NCT02784522;on 19 May 2016.

0.05).There were obvious differences between breast cancer group and benign breast diseases group,other cancers group or healthy persons group in the expression of hMaM mRNA(?~2=8.96,13.49 and 10.32 respectively,P

Purpose: An effective biomarker for the diagnosis of breast cancer (BC) and benign breast diseases (BBD) is crucial for improving the prognosis. We investigated whether N6-methyladenosine (m6A) can be a diagnostic biomarker of BC. Materials and Methods: We detected the contents of peripheral blood m6A in 62 patients with BC, 41 patients with BBD, and 41 normal controls (NCs) using the colorimetric method. The relative expression of the m6A regulated genes methyltransferase-like 14 (METTL14) and fat mass and obesity-associated (FTO) was analyzed using quantitative real-time polymerase chain reaction. Results: m6A in peripheral blood RNA was significantly higher in patients with BC than that in patients with BBD (p < 0.001) or the NCs (p < 0.001). m6A was closely associated with the disease stage (from stage 0 to stage I-IV, p=0.003). The receiver operating characteristic curve of m6A contained an area under the curve (AUC) value of 0.887 in BC, which was greater than that of carcinoembryonic antigen (CEA) or carbohydrate antigen 153 (CA153). The combination of m6A, CEA, and CA153 improved the AUC to 0.914. The upregulated and downregulated mRNA expression of METTL14 and FTO, respectively, might contribute to the increase of m6A in patients with BC. m6A combined with METTL14 and FTO improved the AUC to 0.929 with a specificity of 97.4% in the peripheral blood of patients with BC. Conclusion The peripheral blood RNA of m6A might be a valuable biomarker for the diagnosis of BC.

Purpose: An effective biomarker for the diagnosis of breast cancer (BC) and benign breast diseases (BBD) is crucial for improving the prognosis. We investigated whether N6-methyladenosine (m6A) can be a diagnostic biomarker of BC. Materials and Methods: We detected the contents of peripheral blood m6A in 62 patients with BC, 41 patients with BBD, and 41 normal controls (NCs) using the colorimetric method. The relative expression of the m6A regulated genes methyltransferase-like 14 (METTL14) and fat mass and obesity-associated (FTO) was analyzed using quantitative real-time polymerase chain reaction. Results: m6A in peripheral blood RNA was significantly higher in patients with BC than that in patients with BBD (p < 0.001) or the NCs (p < 0.001). m6A was closely associated with the disease stage (from stage 0 to stage I-IV, p=0.003). The receiver operating characteristic curve of m6A contained an area under the curve (AUC) value of 0.887 in BC, which was greater than that of carcinoembryonic antigen (CEA) or carbohydrate antigen 153 (CA153). The combination of m6A, CEA, and CA153 improved the AUC to 0.914. The upregulated and downregulated mRNA expression of METTL14 and FTO, respectively, might contribute to the increase of m6A in patients with BC. m6A combined with METTL14 and FTO improved the AUC to 0.929 with a specificity of 97.4% in the peripheral blood of patients with BC. Conclusion The peripheral blood RNA of m6A might be a valuable biomarker for the diagnosis of BC.

Objective To investigate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in a new operative position, flank suspended supine position. Methods The new position hold affected flank suspended by raising the ipsilateral shoulder and haunch with two 3-liter saline bags, and set up waist bridge simultaneously. From March 2010 to October 2010, a series of 173 patients underwent PCNL with the new supine position under epidural anesthesia. The average age was (50± 11) years, and the average bulk of the stone was (2. 9±1.0) cm. All patients were placed in the new supine position. Under ultrasound guidance, the desired calix or pelvis was punctured near the posterior axillary line, then dilating the tract and establishing the 16 F or 20 F tract for PCNL. Results The pelvicaliceal system could be successfully approached in all patients. The procedure was well tolerated in all patients. Mean operation time was (86 ± 34) min. 80. 3% of the patients were rendered free of stones by the initial PCNL. Thirty-four cases had residual stones, and a second PCNL was performed in 16 cases to clear the residual stones. Only 1 patient required blood transfusion.None of the patients suffered visceral injury. Conclusion The new supine position is safe and effective for PCNL.

The development of nanomedicine has recently achieved several breakthroughs in the field of cancer treatment; however, biocompatibility and targeted penetration of these nanomaterials remain as limitations, which lead to serious side effects and significantly narrow the scope of their application. The self-assembly of intermediate filaments with arginine-glycine-aspartate (RGD) peptide (RGD-IFP) was triggered by the hydrophobic cationic molecule 7-amino actinomycin D (7-AAD) to synthesize a bifunctional nanoparticle that could serve as a fluorescent imaging probe to visualize tumor treatment. The designed RGD-IFP peptide possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method. This fluorescent nanoprobe with RGD peptide could be targeted for delivery into tumor cells and released in acidic environments such as endosomes/lysosomes, ultimately inducing cytotoxicity by arresting tumor cell cycling with inserted DNA. It is noteworthy that the RGD-IFP/7-AAD nanoprobe tail-vein injection approach demonstrated not only high tumor-targeted imaging potential, but also potent antitumor therapeutic effects in vivo. The proposed strategy may be used in peptide-driven bifunctional nanoparticles for precise imaging and cancer therapy.