Objective: To review the research progress of wrist arthroscopy assisted treatment of distal radius fractures. Methods: To summarize and describe the anatomical characteristics and fracture classification of the distal radius, indications and contraindications of wrist arthroscopy-assisted treatment, surgical methods, and associated soft tissue injuries, and summarize the advantages and disadvantages of the operation through a large number of literature at home and abroad on the treatment of distal radius fractures assisted by wrist arthroscopy. Results: Wrist arthroscopy as a minimally invasive technique for the treatment of distal radius fractures, compared with traditional surgery, can accurately observe intra-articular damage and perform operations under the microscope to avoid secondary damage to blood vessels, nerve, and tendon, etc., and can achieve one-stage repair and reconstruction by repairing the ligament, trigonal fibrocartilage complex, and carpal dislocation. It has the advantages of less trauma, fast postoperative recovery, extensive indications, fewer complications, and satisfactory effectiveness. Conclusion: Wrist arthroscopy has advantages that traditional X-ray film, CT, MRI, and arthrography examinations do not have. Moreover, wrist arthroscopy has achieved satisfactory effectiveness in the adjuvant treatment of intra-articular distal radius fractures.

Objective To discuss the postoperative complications of hypertensive intracerebral hemorrhage treated with freehand drilling skull minimally invasive puncture drainage therapy .Methods The clinical data of 158 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed .The incidence rate ,causes and preventative measures of the postoperative complications of hypertensive intracerebral hemorrhage treated with free -hand drilling skull minimally invasive puncture drainage therapy were analyzed .Results 10 cases of scalp bleeding , 4 cases of epidural hemorrhage , 9 cases of puncture pathway bleeding , 24 cases of secondary bleeding , 1 case of intracranial infection,3 cases of low intracranial pressure ,5 cases of pneumoencephalos and 2 cases died.Conclusion Freehand drilling skull minimally invasive puncture drainage leads to less complications and so far it is a safe and effective therapy for hypertensive intracerebral hemorrhage .

Objective To investigate the activation of nuclear factor-κB(NF-κB),which was stimulated by angiotensin-Ⅱ(AngⅡ)through classical pathway in human pulmonary microvascular endothehal cells(HPMEC).Method The experiment was divided into two groups:in Ang Ⅱ group,HPMECS were incubated with 10-6mol/L AngⅡ for 0,0.5,1,2 and 4 hours,respectively;in losartan group,HPMEC was pretreated with 10-6mol/L losartan(inhibitor of AngⅡ type 1 receptor)for 1 hour,and then stimulated with 10-6mol/L AngⅡ for 2 hours,and the nucleax protein and the cell plasma protein were prepared by lysis and centrifugation.Electrophoretic mobility shift assay(EMSA)was used to detect the NF-κB DNA binding activity.The inhibitor of κBa(IκBα)was detected by Western blotting.The data were expressed as(x±s)and analyzed with one way analysis of variance.A P value less than 0.05 indicated significant difference.Results Compared with the activity of NF-κB at 0 h (100.0±25.1)after AngⅡstimalation,the activity increased significantly at 0.5 hour(144.5±16.1,P＜0.05),and reached peak value at 2 hours(270.1±27.2,P＜0.05).The concentration of IκBα at 0 hours was 44.4%±2.1%,decreased markedly at 0.5 hours(38.9%±3.6%,P＜0.05),and to the lowest level at 2hours(32.6%±2.3%,P＜0.05).The activity of NF-κB(115.4±10.7)and the concentration of IκBα(43.6%±3.7%)in losartan group had ilo significant difference with AngⅡ group at 0 h(P＞0.05).The activity of NF-κB and the concentration of IκBα in losartan group had significant difference with AngⅡ group at 2hours.Conclusions NF-κB can be activated through classical pathway,which stimulated by AngⅡ in HPMEC.

Objective To investigate the carcinogeic role of miR-365 in cuntanerous squamous cell carcinoma (cSCC).Methods Normal HaCaT cells were divided into control and irradiation groups,the later was exposed by UVB irradiation (50 J/m2).MicroRNA expression profiles of the two groups were analyzed by microRNA array.The expression variations of miR-365 in HaCaT,A431,Tca8113 and HSC-1 cells were validated by qRT-PCR analysis.The colony-forming and invasion capacities were dectected by colony forming assay and Transwell migration assay in vitro,respectively.HaCaTpre-miR365-2 highly expressing miR-365 was constructed by retroviral vector infection.Tumorigenicity evaluation was carried out by subcutaneously inject of the cells at the right back flank of nude mice.Results There were 30 microRNAs differentially expressed in HaCaT cells after UVB irradiation and miR-365 was one of the most sensitive miRNAs(as high 6.7 times as control).Expression of miR-365 in all the cSCC cell lines A431,Tca8113 and HSC-1 were significantly higher than that in HaCaT cell,in which the maximum was A431 (15.67 ±1.12 times,P ＜ 0.01),and the minimum was TcaS113 (4.72 ± 0.85 times,P ＜ 0.05).Knockdown of miR-365 in cSCC cell lines significantly inhibited the colony forming ability (t =13.68,P ＜ 0.05) and cell migration (t =19.98,P ＜ 0.05) in vitro.HaCaT cells overexpressing miR-365 by transient transfection significantly increased the ability of colony formation (t =7.11,P ＜ 0.05) and cell migration (t =22.03,P ＜0.05) in vitro.In addition,HaCaTpre-miR-365-2 cell line stably expressing miR-365 could successfully establish tumors in nude mice.Conclusions MiR-365 is an oncogene for cutaneous squamous cell carcinoma.

Objective To review and summarize the experiences of mitral valve replacement in the children aged less than five years.Methods Twelve patients with moderate to severe mitral valve regurgitation (MR) or/and severe mitral valve stenosis (MS) were retrospectively study from January 2008 to December 2011,all of them suffered from severe heart failure and underwent mechanical mitral valve replacement.There were 9 males and 3 females.They aged from 4 to 58 months [mean (26.2 ± 18.1) months] and weighted from 5.6 to 13.0 kg [mean (9.6 ± 3.8) kg].Three patients underwent unsuccessful mitral valve repair before mitral valve replacement.17 to 23 mm aortic bileaflet mechanical prosthesis were reverse directional implanted in nine patients and 25 to 27 mm mitral bileaflet mechanical prosthesis were implanted in three patients.Results One patient died,the operative mortality rate was 8.3％.2 patients were complicated by cardiac arrhythmia and 2 patients complicated by mild hemolysis,all recovered after symptomatic treatment.The heart function of servived 11 patients improved significantly,none of them were complicated by haemorrhage or thromboembolic.Conclusion Severe mitral valve lesion injure heart function significantly for the young children and timely surgical intervention is the only option.Mitral valve replacement is the ultimate option for the patients failed in mitral valve annuloplasty.The introduction of aortic bileaflet mechanical prosthesis which smaller size is available and reverse directional implantation resolve the difficulty of prosthesis-patient mismatch essentially,most children with a small prosthesis has to redo mitral valve replacement with a larger size prosthesis.The compliance of permanent anticoagulation of young children is favourable and more intensively follow-up is essential to avoid the incidence of bleeding and thromboembolic.

Objective To investigate the difference of endothelial cell (EC) in ultrastructure,markers and permeability between blood-brain barrier (BBB) and blood-nerve barrier (BNB).MethodsThe rat brain cortex and sciatic nerve were removed.Ultrastructure of endothelial cell was observed with electron microscopy.Employing immunohistochemical (IHC)staining,the relative distribution was determined for the OX-26,endothelial barrier antigen (EBA)and extravasated fibrinogen around microvessels.ResultsMicrovessels both in BBB and in BNB did share the same tight junctions.However,BNB had a significantly larger number of vesicles than that of BBB.Microvessels in BNB did not express the OX-26 and EBA,but staining weakly positive for fibrinogen,while microvessels in BBB showed strong positive for OX-26 and EBA,perivascular staining of fibrinogen had not been seen.ConclusionTight junctions were present in both BBB and BNB endothelial cell,but there was a significant difference between them in the number of the pinocytotic vesicles,markers expression and permeability.

Objective To establish a canine model with pulmonary thromboembolism(PTE) of selective lobar pulmonary artery embolization mimicking chronic thromboembolism, to assess the effects of an inhaled nitric oxide (NO) 20 ppm on vital signs, blood gas, hemodynamic parameters and neutrophils in the alveolar of the canine model. Methods Twenty canines were divided into four groups: group 1: sham group (n=5); group 2; ischemic lung group (PTE group without embolectomy, n=5); group 3; reperfusion lung group (PTE group with embolectomy, n=5); group 4: reperfusion lung group with inhaled NO (PTE group inhaled 20 ppm NO after embolectomy, n=5). And central venous pressure (CVP), mean pulmonary arterial pressure (MPAP), pulmonary arterial wedge pressure (PAWP) and carbon monoxide (CO) were recorded, pulmonary vascular resistance (PVR) was also calculated. Vital signs, blood gases were measured before embolectomy and at 2, 4, 6 hours after the operation. Albumin in bronchoalveolar lavage fluid (BALF) was measured by chromatometry of Coomassie brilliant blue. Lung wet to dry weight ratio(W/D) was also measured. Lung tissue pathology and alveolar PMN in the left lower lobar were observed by optical microscopy. Results MPAP increased significantly at 2 hours after reperfusion [(3. 20±0.53)kPa vs. (2. 27±0. 67)kPa,F=63,P=0.02]; At 6 hours after reperfusion as compared with baseline,HR increased significantly [(175±8) beats/min vs. (155±5) beats/min, F=38.72, P=0.01],PaO_2/FiO_2 also decreased significantly (41.70±8.04 vs. 54.71±3.78,F=48.36,P=0.03). MPAP decreased significantly in group 4 as compared with group 3 at 2 hours after reperfusion [(2.53±0.4)kPa vs. (3. 20±0. 53)kPa,F=55,P=0.04]. At 4 hours after reperfusion,PaO_2/FiO_2 raised in group 4,but there was no significant difference as compared with group 3 (49.17±7.37 vs. 39.71±7.31, F=2.36, P=0. 11). The quantities of alveolar PMN infiltration in group 4 decreased significantly as compared with group 3 (19±6/10 HPF vs. 31±11/10 HPF, F=98, P=0.01).Conclusions Lung ischemia-reperfusion injury can be induced by embolectomy from lower pulmonary artery in the PTE model embolized for one week. An inhaled NO 20 ppm can decrease the elevated pulmonary artery pressure induced by ischemia-reperfusion injury and may alleviate the injury by reducing the PMN immigration into the alveoli.

Objective To evaluate the vascular endothelial dilatation function in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Thirty elderly patients with moderate to severe OSAHS and twenty-eight control subjects were studied. Their blood concentration of nitric oxide (NO) were quantified. Brachial artery diameter was measured with Doppler ultrasound under baseline conditions, during reactive hyperemia (an endothelium-dependent dilatation) and after sublingual administration of nitroglycerin ( an endothelium-independent vasodilator). The dilative rate of brachial artery in different conditions was calculated to evaluate the endothelial function. Subjects with OSAHS were treated by nasal continuous positive airway pressure (nCPAP) for 4 weeks, and the level of NO in plasma and vascular endothelial function were measured. Results Compared with control group, there was a significant decrease of NO level in elderly patients with moderate to severe OSAHS [(50. 35±8.65)μmol/L vs. (57.31±9.31)μmol/L, t=2.95,P=0.005], and the level of NO in plasma was increased after nCPAP treatment for 4 weeks [(55.77±8.87)μmol/L vs. (50.35± 8.65)μmol/L,t=2.40,P=0.023. The elderly patients with moderate to severe OSAHS had lower endothelium-dependent flow-mediated dilation (FMD) compared with control subjects [(9.78± 4.82)%vs. (13.21±5.81)%,t=2.45, P=0.017], and there was no significant difference in endothelium-independent nitroglycerin ( NTG)-induced dilation [( 16.87±6.15)% vs. (14.74 ± 5.82)%,t=1.36,P=0.18]. After nCPAP treatment for 4 weeks, the patients with moderate to severe OSAHS had significant increase in FMD[(14.33±6.13)% vs. (9.78±4.82)%, t=3.20,P= 0.002], whereas there was no significant change in NTG-induced dilation [(14.74±5.82)% vs. (15.15±4.21)%, t=0.31,P=0.76]. Conclusions The elderly patients with moderate to severe OSAHS have abnormal vascular endothelial function, and nCPAP treatment can reverse the dysfunction effectively, which may be associated with the reversal of intermittent hypoxia.

In order to compensate for the deficiencies of current medical education, improve the comprehensive quality of medical students, the First Clinical College, Tongji Medical College of Huazhong University of Science and Technology took the lead in carrying out the health management practice of rela-tives and friends, and made a beneficial exploration of humanistic education for medical students. Relatives and friends were regarded as the specific practice objects, and by telephone and network at school, face-to-face communication during the vacation, medical students established, managed and track the health records of relatives and friends. The students could practice while learning, which made medical students, in im-proving the knowledge structure, enhance their emotional communication with friends and relatives, improve their doctor-patient communication ability, establish the concept of humanistic care, and cultivate their occupation moral respect for life and their dedication to medicine and the sense of responsibility and mission to the society. It provides a new strategy for medical humanities education.

Objective To investigate the difference of standard tangential field and multiple fileld radiotherapy in axillary lymph node after conserving surgery,to provide a reference for clinical treatment.Methods 20 cases of left breast cancer patients were selected,all patients underwent breast -conserving surgery,postoperative radiothera-py.All patients used standard radiotherapy wild tangent based and reverse -intensity modulated radiation therapy optimization.Armpit I,Ⅱ lymph nodes were used to calculate the extent of coverage of the original plan,target dose uniformity HI,dose conformal CI,dosimetric parameters were calculated.Results Under standard tangential field irradiation,I stand mean dose was (33.95 ±8.24)Gy,which was significantly higher than Ⅱ station (22.13 ± 6.67)Gy,and V50,V45,V40 were (22.45 ±6.32)%,(39.83 ±7.54)%,(49.65 ±8.31)%,which were higher than Ⅱ stand,I stand irradiation was significantly more,the differences were statistically significant (t =5.632,P =0.009;t =7.214,P =0.000;t =8.954,P =0.000;t =6.121,P =0.002).The whole breast irradiation armpit IMRT plan,19 patients (95.00%)reached 95% by volume APTV≥50Gy,coverage was better;but HI,CI were (1.11 ± 0.03),(1.36 ±0.07)respectively,which were significantly worse than the standard wild tangent,the differences were statistically significant (t =6.584,P =0.001;t =9.144,P =0.000).Under Hatano IMRT irradiation ipsilateral lung,heart suffered an average dose of (1 694.58 ±102.31)cGy,(645.54 ±74.44)cGy,which were significantly more than the standard tangential field irradiation,the differences were statistically significant (t =7.654,P =0.000;t =6.654,P =0.001).Conclusion Standard tangential field irradiation has poor coverage in Ⅱ axillary lymph node station,irradiation intensity modulated radiation has better coverage,but significantly increased the dose to normal tissues.